Is the single use of intraoperative 5-fluorouracil in filtering surgery for high-risk cases enough?

Eye (Lond). 1998;12 ( Pt 3a):374-8. doi: 10.1038/eye.1998.89.

Abstract

Purpose: To study the efficacy of the adjunctive use of a single intraoperative application of 5-fluorouracil (5FU) in eyes with poor prognoses for a successful outcome with a trabeculectomy.

Method: Twenty-four patients (25 eyes) with a mean age of 63.7 +/- 14.7 years (range 27-86 years) and a history of one or more risk factors (age < 50 years, more than 3 years on topical medication, a previous failed filter, previous cataract surgery, uveitis, neovascular glaucoma) underwent trabeculectomy with the intraoperative application of 5FU on a sponge (25 mg/ml) for 5 min. The average follow-up was 10.1 +/- 5.5 months.

Results: The mean pre-operative intraocular pressure (IOP) was 24.7 +/- 6.2 mmHg and the mean post-operative IOP was 13.9 +/- 3.5 mmHg. Success, defined as an IOP within desired target levels for a particular eye, in the presence of a functioning filter, without supplementary medical therapy, was achieved in 56.5% of cases.

Conclusions: Our results of successful filters in this group of patients with moderate- to high-risk characteristics approach similar figures quoted for trabeculectomies without the adjunctive use of intraoperative 5FU in eyes with poor prognoses with a similar length of follow-up. Though the numbers are small there is a trend that indicates that the intraoperative application of a single dose of 5FU alone may not be sufficient in eyes with moderate- to high-risk characteristics of failure of a trabeculectomy.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antimetabolites / administration & dosage*
  • Drug Administration Schedule
  • Female
  • Fluorouracil / administration & dosage*
  • Follow-Up Studies
  • Humans
  • Intraoperative Care*
  • Male
  • Middle Aged
  • Postoperative Complications / prevention & control*
  • Prognosis
  • Risk Factors
  • Trabeculectomy*
  • Treatment Outcome

Substances

  • Antimetabolites
  • Fluorouracil