Initial 5-fluorouracil trabeculectomy in young patients.
The effectiveness of initial trabeculectomy with adjunctive 5-fluorouracil (5-FU) for uncomplicated glaucoma in patients age 40 years or younger at the time of surgery was evaluated retrospectively in a consecutive series of 20 eyes of 20 patients. Fifteen patients had juvenile primary open-angle glaucoma, 4 had pigmentary glaucoma, and 1 had glaucoma associated with angle recession. Mean patient age was 26.8 +/- 9.7 years (range, 13 to 40 years) at the time of surgery. The mean total 5-FU dose administered was 27.8 +/- 8.8 mg (range, 15 to 45 mg). The intraocular pressure (IOP) decreased from 34.4 +/- 11.5 mmHg preoperatively to 10.5 +/- 4.0 mmHg postoperatively after a mean follow-up of 31.1 +/- 17.3 months (range, 11.5 to 70 months). Nineteen eyes (95%) had a postoperative IOP of 20 mmHg or less without pressure-lowering medications. One patient required additional medical therapy to control the IOP. Complications included bleb-related endophthalmitis (2 eyes) and hypotony maculopathy (1 eye).
Whiteside-Michel
J
J
Department of Ophthalmology, New York Eye and Ear Infirmary, NY 10003.
Liebmann
J M
JM
Ritch
R
R
D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy; D005069:Evaluation Studies as Topic; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D008297:Male; D012189:Retrospective Studies; D014130:Trabeculectomy / Q000009:adverse effects; D014792:Visual Acuity
D005472:Fluorouracil