[Single dose intraoperative administration of 5-fluorouracil (5-FU) in trabeculectomy. Long-term results of a pilot study].
5-Fluorouracil (5-FU) improves the success of trabeculectomy. Since in vitro studies showed a prolonged effect of 36 days of growth inhibition with a single dose of 5-FU, 5-FU is applied intraoperatively. To evaluate the effect of intraoperatively applied 5-FU, we compared 13 (low-risk) patients with intraoperative application of 5-FU to a control group matched by age, diagnosis, sex and stage of glaucoma. Postoperatively on day 4 the IOP was significant lower (4.8 mmHg) in the 5-FU-group in comparison to the untreated group (P = 0.005; power 0.80). After 1 week the difference decreased to 2 mmHg and was not significant any more (P = 0.16). After 1 week a lower mean intraocular pressure of 2 mmHg was found with a P-value of 0.16. It may be that these results are not just due to an antiproliferative mechanism; a direct toxic effect of 5-FU should be considered. 5-FU side effects such as corneal complications and inflammatory reaction were not increased in the 5-FU group. However, one case of persistent hypotony was seen in the 5-FU group. This study found intraoperative use of 5-FU to be a safe procedure with a pronounced capacity to lower IOP in the direct postoperative phase. However, this effect may not be based on an antiproliferative effect alone, but might be of toxic origin.
Spiegel
D
D
Klinik und Poliklinik der Universität Regensburg.
Sachs
H
H
Yanes
G
G
D000368:Aged; D000963:Antimetabolites / Q000008:administration & dosage*; D002455:Cell Division / Q000187:drug effects; D017889:Exfoliation Syndrome / Q000601:surgery*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage*; D005902:Glaucoma, Open-Angle / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D010865:Pilot Projects; D014129:Trabecular Meshwork / Q000187:drug effects; D014130:Trabeculectomy
D000963:Antimetabolites; D009883:Ophthalmic Solutions; D005472:Fluorouracil