Trabeculectomy with intraoperative sponge 5-fluorouracil.
OBJECTIVE
To retrospectively assess the outcome of trabeculectomy surgery performed using intraoperative sponge 5-fluorouracil (5-FU) (50 mg/ml).


METHODS
Trabeculectomy with intraoperative sponge 5-FU was performed on 140 eyes of 119 patients. The reduction in intraocular pressure (IOP), the number of supplementary postoperative injections, and any treatment complications were noted.


RESULTS
The mean preoperative IOP was 25.7 +/- 8.6 mmHg. The mean postoperative IOP was 12.5 +/- 5.7 mmHg with a mean IOP reduction of 52 percent (P < 0.0001). One hundred twenty-one (86.4 percent) eyes required no postoperative glaucoma medications, with the mean number of glaucoma medications dropping from 2.5 +/- 1.1 before operation to 0.3 +/- 0.8 after operation (P < 0.001). One hundred five eyes received a mean of 5.3 +/- 2.7 postoperative 5-FU injections. There was no significant difference in final IOP or success rate between low- and high-risk eyes, but high-risk eyes seemed to require supplementary postoperative 5-FU. Corneal epithelial damage arose in 52 (37 percent) eyes and correlated strongly with postoperative 5-FU supplementation.


CONCLUSIONS
Intraoperative sponge 5-FU is a reasonably safe and effective adjunct to trabeculectomy surgery.
Mora
J S
JS
Glaucoma Research and Education group, San Francisco, CA USA.
Nguyen
N
N
Iwach
A G
AG
Gaffney
M M
MM
Hetherington
J
J
Hoskins
H D
HD
Wong
P C
PC
Tran
H
H
Dickens
C J
CJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000963:Antimetabolites / Q000009:adverse effects / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects / Q000627:therapeutic use*; D005901:Glaucoma / Q000628:therapy*; D006801:Humans; D007429:Intraocular Pressure; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015503:Surgical Sponges; D014130:Trabeculectomy / Q000009:adverse effects; D016896:Treatment Outcome
D000963:Antimetabolites; D005472:Fluorouracil