Is the single use of intraoperative 5-fluorouracil in filtering surgery for high-risk cases enough?
OBJECTIVE
To study the efficacy of the adjunctive use of a single intraoperative application of 5-fluorouracil (5FU) in eyes with poor prognoses for a successful outcome with a trabeculectomy.


METHODS
Twenty-four patients (25 eyes) with a mean age of 63.7 +/- 14.7 years (range 27-86 years) and a history of one or more risk factors (age < 50 years, more than 3 years on topical medication, a previous failed filter, previous cataract surgery, uveitis, neovascular glaucoma) underwent trabeculectomy with the intraoperative application of 5FU on a sponge (25 mg/ml) for 5 min. The average follow-up was 10.1 +/- 5.5 months.


RESULTS
The mean pre-operative intraocular pressure (IOP) was 24.7 +/- 6.2 mmHg and the mean post-operative IOP was 13.9 +/- 3.5 mmHg. Success, defined as an IOP within desired target levels for a particular eye, in the presence of a functioning filter, without supplementary medical therapy, was achieved in 56.5% of cases.


CONCLUSIONS
Our results of successful filters in this group of patients with moderate- to high-risk characteristics approach similar figures quoted for trabeculectomies without the adjunctive use of intraoperative 5FU in eyes with poor prognoses with a similar length of follow-up. Though the numbers are small there is a trend that indicates that the intraoperative application of a single dose of 5FU alone may not be sufficient in eyes with moderate- to high-risk characteristics of failure of a trabeculectomy.
Prince Charles Eye Unit, King Edward VII Hospital, Windsor, UK.
P
P
Watts
N
N
Karia
J
J
McAllister
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000963:Antimetabolites / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011379:Prognosis; D012307:Risk Factors; D014130:Trabeculectomy; D016896:Treatment Outcome
D000963:Antimetabolites; D005472:Fluorouracil