A prospective trial of intraoperative fluorouracil during trabeculectomy in a black population.
In a study population of black Africans with advanced glaucoma in Ghana we conducted a prospective study of intraoperative 5-fluorouracil alone. Eyes undergoing trabeculectomy were randomly selected either to receive or not receive a single intraoperative application of 5-fluorouracil (50 mg/ml for five minutes). Fifty-five eyes had a mean follow-up of 282 days (minimum, 92 days). Twenty of 24 eyes (83%) in the 5-fluorouracil group vs 12 of 31 eyes (39%) in the control group had postoperative intraocular pressure of 20 mm Hg or less with or without medical therapy (P = .01). Eleven of 24 eyes (46%) in the 5-fluorouracil group and five of 31 eyes (16%) in the control group had intraocular pressure of 15 mm Hg or less (P = .02). Without medical therapy, 17 of 24 eyes (71%) in the 5-fluorouracil group and ten of 31 eyes (32%) in the control group had intraocular pressure of 20 mm Hg or less (P = .02). The overall complications were similar in the two groups. In this population, intraoperative 5-fluorouracil markedly improved the ability of trabeculectomy to lower intraocular pressure. We recommend that intraoperative 5-fluorouracil be considered in glaucoma surgery with poor prognosis as an alternative to postoperative subconjunctival injections when multiple injections are not feasible.
Egbert
P R
PR
Department of Ophthalmology, Stanford University Medical Center, CA 94305-5308.
Williams
A S
AS
Singh
K
K
Dadzie
P
P
Egbert
T B
TB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage* / Q000627:therapeutic use; D005500:Follow-Up Studies; D005869:Ghana; D015812:Glaucoma, Angle-Closure / Q000188:drug therapy / Q000208:ethnology / Q000601:surgery*; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000208:ethnology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014130:Trabeculectomy
D005472:Fluorouracil