5-fluorouracil and glaucoma filtering surgery. II. A pilot study.
5-Fluorouracil (5-FU) was injected subconjunctivally after glaucoma filtering surgery in a pilot study of eyes with poor surgical prognoses. Twenty-seven (79%) of the 34 aphakic eyes with glaucoma achieved an intraocular pressure (IOP) of less than or equal to 21 mmHg (range of follow-up on nonreoperated eyes, 91 -468 days). Nine (69%) of 13 eyes with neovascular glaucoma achieved an IOP of less than or equal to 21 mmHg (range of follow-up on nonreoperated eyes, 120-379 days). Eight (89%) of nine phakic eyes with glaucoma following unsuccessful filtering procedures achieved an IOP of less than or equal to 21 mmHg (range of follow-up on nonreoperated eyes, 134-394 days). Visual acuities remained within one line of their preoperative levels or improved in 32 (94%) of the 34 aphakic eyes with glaucoma, eight (62%) of the 13 eyes with neovascular glaucoma, and six (67%) of the nine phakic eyes with glaucoma following unsuccessful filtering procedures. Postoperative corneal epithelial defects occurred in 45% of the cases. Conjunctival wound and conjunctival needle tract leaks were observed in 41% of the cases, but only one eye required wound revision. No other serious side effects that we attributed to 5-FU were observed. It seems that postoperative subconjunctival 5-FU increases the likelihood of achieving IOP control following filtering surgery in eyes with poor surgical prognoses; however, a randomized clinical trial is necessary to confirm this.
D000293:Adolescent; D000328:Adult; D000368:Aged; D002387:Cataract Extraction; D002648:Child; D002921:Cicatrix / Q000517:prevention & control*; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D005347:Fibroblasts / Q000187:drug effects; D005472:Fluorouracil / Q000627:therapeutic use*; D005500:Follow-Up Studies; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D053685:Laser Therapy; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000601:surgery; D010865:Pilot Projects; D011182:Postoperative Care; D011183:Postoperative Complications / Q000601:surgery; D014792:Visual Acuity / Q000187:drug effects
D005472:Fluorouracil