Risk of hypotony after primary trabeculectomy with antifibrotic agents in a black west African population

J Glaucoma. 1998 Apr;7(2):82-5.


Purpose: To evaluate the risk of hypotony and hypotony maculopathy following trabeculectomy with 5-fluorouracil (5-FU) and mitomycin C (MMC) in a black West African population.

Methods: One hundred and one eyes of black Ghanaian patients with advanced primary open-angle glaucoma received intraoperative antifibrotic therapy with trabeculectomy as part of two randomized clinical trials. Overall, 57 patients received 5-FU (50.0 mg/ml for 5 minutes) and 44 received MMC (0.5 mg/ml for 3.5 minutes). All cases were performed by one of five surgeons at a single outpatient surgery center.

Results: Two of 101 eyes had a final intraocular pressure (IOP) of less than 5 mm Hg and were thus classified as having hypotony. No patient in either group was noted to develop hypotony-related maculopathy. Overall mean pre- and postoperative IOPs were 30.1 and 15.9 mm Hg, respectively. The patients receiving intraoperative MMC had a lower mean postoperative IOP (14.7 mm Hg) than those receiving 5-FU (first study, 17.1 mm Hg; second study, 16.7 mm Hg; p = 0.05). Mean overall follow-up was 17.7 months and did not differ significantly between the MMC and combined 5-FU groups.

Conclusion: Hypotony following trabeculectomy supplemented with antifibrotic agents is a rare complication in this population. No eyes in either clinical trial developed hypotony maculopathy, suggesting that the prevalence of this condition is substantially lower in black West Africans than in whites.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Fluorouracil / administration & dosage
  • Fluorouracil / adverse effects*
  • Follow-Up Studies
  • Ghana / epidemiology
  • Glaucoma, Open-Angle / drug therapy
  • Glaucoma, Open-Angle / ethnology
  • Glaucoma, Open-Angle / surgery*
  • Humans
  • Intraocular Pressure
  • Intraoperative Period
  • Macular Degeneration / epidemiology
  • Macular Degeneration / etiology
  • Middle Aged
  • Mitomycin / administration & dosage
  • Mitomycin / adverse effects*
  • Ocular Hypotension / epidemiology*
  • Ocular Hypotension / etiology
  • Ophthalmic Solutions
  • Postoperative Complications
  • Retrospective Studies
  • Risk Factors
  • Trabeculectomy / adverse effects*


  • Ophthalmic Solutions
  • Mitomycin
  • Fluorouracil