title: Use of antifibrosis agents and glaucoma drainage devices in the American and Japanese Glaucoma Societies.
abstract: OBJECTIVE
  To investigate practice patterns among glaucoma subspecialists in the American Glaucoma Society (AGS) and the Japanese Glaucoma Society (JGS), regarding use of antifibrosis agents and glaucoma drainage devices.
  
  
  METHODS
  An anonymous survey incorporating 10 clinical situations was mailed to all AGS and JGS members in December 1995.
  
  
  RESULTS
  Half of the AGS (105 of 210), and JGS (25 of 50) members returned surveys. Most respondents (51-87%) preferred trabeculectomy with adjunctive mitomycin for all 10 clinical situations. Mitomycin concentrations varied from 0.1 to 0.8 mg/ml (range of means for 10 situations 0.31-0.39 mg/ml) and intraoperative application times ranged from 5 s to 7 min (range of means for 10 situations 2.5-4.6 min). Preferences for either no antifibrosis agent (up to 39%) or 5-fluorouracil (up to 29%) were highest in primary trabeculectomy. Thirty-seven percent to 64% of AGS members used glaucoma drainage devices, especially after complicated postsurgical glaucomas (after penetrating keratoplasty, scleral buckling, or pars plana vitrectomy) and in neovascular glaucoma, but few JGS members used them. Large differences between university- and private practice-based AGS members were found only in mitomycin use for primary trabeculectomy (33% vs. 52%, respectively; p = 0.07) and for complicated postsurgical glaucomas (46% vs. 70%, respectively; p = 0.03).
  
  
  CONCLUSIONS
  Trabeculectomy with mitomycin was the preferred surgical procedure among AGS and JGS members in the clinical situations surveyed. Mitomycin concentration and time of application varied widely. Many respondents used 5-fluorouracil or no antimetabolite in primary trabeculectomy. Glaucoma drainage devices were widely used for complicated glaucomas in the United States.
authors.affiliation: Bascom Palmer Eye Institute, University of Miami School of Medicine, Florida, USA.
authors.forename: P P
authors.initials: PP
authors.lastname: Chen
authors.forename: T
authors.initials: T
authors.lastname: Yamamoto
authors.forename: A
authors.initials: A
authors.lastname: Sawada
authors.forename: R K
authors.initials: RK
authors.lastname: Parrish
authors.forename: Y
authors.initials: Y
authors.lastname: Kitazawa
mesh_terms: D017024:Chemotherapy, Adjuvant; D003625:Data Collection; D004305:Dose-Response Relationship, Drug; D004322:Drainage / Q000295:instrumentation*; D005355:Fibrosis / Q000517:prevention & control; D005472:Fluorouracil / Q000008:administration & dosage / Q000627:therapeutic use*; D005901:Glaucoma / Q000628:therapy*; D006801:Humans; D007564:Japan; D008937:Mitomycins / Q000008:administration & dosage / Q000627:therapeutic use*; D009883:Ophthalmic Solutions; D010818:Practice Patterns, Physicians'; D019736:Prostheses and Implants; D012189:Retrospective Studies; D012955:Societies, Medical; D014130:Trabeculectomy; D014481:United States
chemical_list: D008937:Mitomycins; D009883:Ophthalmic Solutions; D005472:Fluorouracil