Use of trabeculectomy with postoperative 5-fluorouracil in patients requiring extremely low intraocular pressure levels to limit further glaucoma progression.
The authors conducted a randomized, controlled clinical trial to quantify the effect of 5-fluorouracil (5-FU) on filtration surgery. Both eyes of 17 patients with either bilateral low-tension glaucoma or advanced chronic open-angle glaucoma that would be expected to progress at intraocular pressures in the normal range were included. One eye received a full-thickness filtering procedure with a modified shell tamponade technique, and the other received a trabeculectomy with postoperative 5-FU. Follow-up was equal for both eyes and averaged 9.2 months. In eyes in the shell group, the average postoperative pressure was 10.94 mmHg, and in the 5-FU group it was 6.94 mmHg, (P = 0.0001). However, the postoperative visual acuity decrease was significantly greater in the 5-FU group (P less than 0.05). Choroidal detachments also were more frequent in the 5-FU group, but this was not statistically significant.
Wilson
R P
RP
Wills Eye Hospital, Department of Ophthalmology, Thomas Jefferson University Medical School, Philadelphia, PA 19107.
Steinmann
W C
WC
D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000517:prevention & control / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications; D014130:Trabeculectomy; D014792:Visual Acuity / Q000187:drug effects
D005472:Fluorouracil