Effects of intraoperative 5-fluorouracil or mitomycin C on glaucoma filtration surgery in the rabbit.
OBJECTIVE
To establish the effects of single intraoperative exposures to either 5-fluorouracil (5-FU) or two different concentrations of mitomycin C (MMC) on filtration surgery in the rabbit.


METHODS
A prospective, randomized, masked-observer, placebo-controlled study was performed to compare the effects on filtration surgery in rabbits of a single 5-minute intraoperative exposure to 5-FU (50 mg/ml), MMC (0.2 mg/ml), or MMC (0.4 mg/ml) with control eyes treated with distilled water.


RESULTS
Intraocular pressures (IOPs) remained lower for longer and bleb survival was increased (P < 0.05) with all three treatments compared with control eyes. The effect of 5-FU was more transient than MMC. Bleb survival was prolonged in the following order: MMC 0.4 > MMC 0.2 > 5-FU 50 mg/ml. At 30 days, blebs were present in 100% of eyes treated with MMC 0.4 mg/ml, 60% of eyes treated with MMC 0.2 mg/ml, and 0% of eyes treated with 5-FU 50 mg/ml or distilled water. The blebs in the eyes treated with MMC were thinner, and significant complications (endophthalmitis, transient corneal opacification and neovascularization, and a presumed bleb leak) only occurred in the eyes treated with MMC 0.4 mg/ml.


CONCLUSIONS
The authors' results suggest that 5-FU and MMC at these concentrations, delivered as a single intraoperative dose, prolong the survival of filtration surgery for different lengths of time in the rabbit, which is a model that normally exhibits aggressive healing and rapid failure of filtration surgery. The implications of these potentially titratable effects for filtration surgery in different categories of patients are discussed.
Khaw
P T
PT
Institute for Wound Research, J. Hillis Miller Health Center, University of Florida, Gainesville.
Doyle
J W
JW
Sherwood
M B
MB
Smith
M F
MF
McGorray
S
S
D000818:Animals; D004311:Double-Blind Method; D004353:Drug Evaluation, Preclinical; D005472:Fluorouracil / Q000008:administration & dosage*; D005901:Glaucoma / Q000188:drug therapy* / Q000601:surgery*; D007429:Intraocular Pressure; D007430:Intraoperative Care; D016685:Mitomycin / Q000008:administration & dosage*; D010919:Placebos; D011446:Prospective Studies; D011817:Rabbits; D011897:Random Allocation; D014130:Trabeculectomy
D010919:Placebos; D016685:Mitomycin; D005472:Fluorouracil