Late bleb leakage after trabeculectomy with 5-fluorouracil or mitomycin C.
OBJECTIVE
To determine the prevalence of late filtering bleb leakage after trabeculectomy performed with intraoperative adjunctive use of 5-fluorouracil (5-FU) or mitomycin C.


METHODS
Case series.


METHODS
Private clinic in São Paulo.


METHODS
Forty-seven consecutive patients (47 eyes) who had previously undergone trabeculectomy with intraoperative application of either 5-FU (25 mg/mL) or mitomycin C (0.2 mg/mL) and who had functioning filtering blebs. The patients who received 5-FU had advanced primary open-angle glaucoma without previous surgery; those who received mitomycin C had either previous failed filtering surgery or refractory glaucoma. All patients had been followed for at least 6 months.


METHODS
Slit-lamp appearance of bleb, bleb leakage, as determined with the Seidel test.


RESULTS
None of the eyes had spontaneous bleb leakage. Ten (32.2%) of the 31 eyes that received 5-FU and 5 (31.2%) of the 16 eyes that received mitomycin C had induced bleb leakage. Thirty filtering blebs were classified as transparent, 10 as vascularized and 7 as ischemic. The rates of bleb leakage for the three groups were 46.7%, 0% and 14.3% respectively (p = 0.012).


CONCLUSIONS
The importance of late bleb leakage in patients who receive intraoperative 5-FU or mitomycin C in predisposing these eyes to late complications, such as endophthalmitis and hypotony, needs to be evaluated.
Susanna
R
R
Department of Ophthalmology, University of São Paulo, Brazil.
Takahashi
W
W
Nicolela
M
M
D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects*; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000009:adverse effects*; D019384:Nucleic Acid Synthesis Inhibitors / Q000009:adverse effects*; D011183:Postoperative Complications / Q000139:chemically induced*; D012189:Retrospective Studies; D014130:Trabeculectomy
D019384:Nucleic Acid Synthesis Inhibitors; D016685:Mitomycin; D005472:Fluorouracil