Low-dose perioperative 5-fluorouracil in trabeculectomy.
OBJECTIVE
5-Fluorouracil (5-FU) has been used to improve the outcome of trabeculectomy in high-risk cases, employing a postoperative regimen of subconjunctival injections. In light of recent laboratory evidence of the use of perioperative exposure to 5-FU, the authors investigated the outcome of this approach in their patients.


METHODS
Twenty-three eyes of 21 patients who underwent trabeculectomy with a perioperative application of low-dose (25 mg/ml) 5-FU, with a minimum follow-up of 1 year, were reviewed retrospectively.


RESULTS
At 1 year postoperatively, 15 (65%) of the eyes had an intraocular pressure (IOP) of less than 21 mm Hg without treatment and 3 (13%) of the eyes achieved the same IOP with the same number of or fewer medications compared with on admission. The outright successful patients had a significantly shorter disease duration than the remaining patients (P < .05), despite having used a similar number of treatments on admission, and also had a significantly lower mean number of indications for antimetabolite use (P < .02). Few complications attributable to 5-FU were noted.


CONCLUSIONS
This route of administration appears to be safe and effective in patients requiring trabeculectomy who are not at a high risk for failure.
Hugkulstone
C E
CE
Department of Ophthalmology, University Hospital, Nottingham, United Kingdom.
Vernon
S A
SA
D000963:Antimetabolites / Q000008:administration & dosage*; D004333:Drug Administration Routes; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage*; D005500:Follow-Up Studies; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome
D000963:Antimetabolites; D005472:Fluorouracil