Glaucoma filtering surgery with 5-fluorouracil.
A life-table analysis of surgical outcomes was performed on the first eye of 155 patients who were enrolled in a pilot study of glaucoma filtering surgery with postoperative subconjunctival 5-fluorouracil (5-FU) injections. The success rates at 1-, 2-, and 3-year intervals were 68, 63, and 63%, respectively, for 88 patients with non-neovascular glaucoma in aphakia; 82, 75, and 75% for 39 patients with non-neovascular glaucoma after unsuccessful filtering surgery; and 68% at each yearly interval for 28 patients with neovascular glaucoma. Complications which resulted from filtering surgery and the 5-FU injections included corneal epithelial defects (55.5%), conjunctival wound leaks (36.8%), suprachoroidal hemorrhage (5.8%), rhegmatogenous retinal detachment (2.6%), endophthalmitis and phthisis (1.9% each), and corneal scarring, late bleb leak, malignant glaucoma, and traction retinal detachment (1.3% each). A Cox Model regression analysis failed to demonstrate a correlation between surgical success and age, race, type of filtering procedure, or total dose of 5-FU received. Postoperative subconjunctival 5-FU may increase the operative success rate for selected patients with a high risk for failure after glaucoma filtering surgery.
Rockwood
E J
EJ
Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami School of Medicine.
Parrish
R K
RK
Heuer
D K
DK
Skuta
G L
GL
Hodapp
E
E
Palmberg
P F
PF
Gressel
M G
MG
Feuer
W
W
D000206:Actuarial Analysis; D003228:Conjunctiva; D005472:Fluorouracil / Q000009:adverse effects / Q000627:therapeutic use*; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007267:Injections; D010865:Pilot Projects; D011182:Postoperative Care; D011184:Postoperative Period; D014792:Visual Acuity
D005472:Fluorouracil