Trabeculectomy with intraoperative 5-fluorouracil vs mitomycin C.
OBJECTIVE
To compare the effectiveness of intraoperative 5-fluorouracil (5-FU) and mitomycin C used adjunctively with trabeculectomy in a black West African population.


METHODS
Eighty-five consecutive eyes of 85 black patients undergoing primary trabeculectomy for open-angle glaucoma were prospectively randomly assigned to receive either 5-FU (50 mg/ml for 5 minutes) or mitomycin C (0.5 mg/ml for 3 1/2 minutes) intraoperatively by soaked sponge.


RESULTS
Of the 81 eyes with at least a 3-month postoperative follow-up, 41 of 44 (93.2%) in the mitomycin C group and 27 of 37 (73.0%) in the 5-FU group had a final intraocular pressure of less than 21 mm Hg (P = .01). Twenty-eight of 44 eyes (63.6%) in the mitomycin C group and 18 of 37 (51.4%) in the 5-FU group had a final intraocular pressure of less than 15 mm Hg (P = .26). Mean postoperative intraocular pressure was 13.7 mm Hg in the mitomycin C group and 16.3 mm Hg in the 5-FU group (P = .05). There were no differences between the two groups in mean age, preoperative intraocular pressure, postoperative visual acuity, and complications. Mean follow-up was 10.0 +/- 4.41 months (range, 4 to 19 months).


CONCLUSIONS
The adjunctive use of mitomycin C with trabeculectomy is equally safe and more efficacious compared to 5-FU in this West African population. Use of mitomycin C in this study was not associated with a statistically significantly greater proportion of patients achieving low intraocular pressure (less than 15 mm Hg) compared to 5-FU.
Singh
K
K
Department of Ophthalmology, Stanford University Medical Center, CA 94305-5308, USA. kuldev.singh@forsythe.stanford.edu
Egbert
P R
PR
Byrd
S
S
Budenz
D L
DL
Williams
A S
AS
Decker
J H
JH
Dadzie
P
P
D000963:Antimetabolites / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects / Q000627:therapeutic use*; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D008937:Mitomycins / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D014130:Trabeculectomy; D016896:Treatment Outcome; D014792:Visual Acuity / Q000187:drug effects
D000963:Antimetabolites; D008937:Mitomycins; C102065:mitomycin D; D005472:Fluorouracil