Comparison of phacotrabeculectomy with 5-fluorouracil, mitomycin-C, and without antifibrotic agents.
OBJECTIVE
To evaluate the potential benefits, complications, and prognostic risk factors for failure of phacotrabeculectomy performed with or without 5-fluorouracil (5-FU) and mitomycin-C (MMC).


METHODS
Retrospective chart review of 78 patients who underwent phacotrabeculectomy during a 2-year period. Patients were divided into 3 groups, those who received 5-FU (N = 28). MMC (N = 29), or no antifibrotic agent (N = 21).


RESULTS
All 3 groups had statistically significant lower intraocular pressures (IOP) on fewer antiglaucomatous medications at 6-month, 12-month, and last follow-up compared to preoperative levels (P < .05). Intraocular pressures were lower in the group that received MMC compared to the 5-FU group, but not in the group that did not receive antimetabolites, at all time intervals measured (P < .05). Black race was a strong predictor of failure of trabeculectomy (P = 009). No differences in final visual acuity or complications were found between groups.


CONCLUSIONS
Phacotrabeculectomy is effective regardless of antimetabolite use. Race is a strong predictor of failure.
Budenz
D L
DL
Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, Philadelphia, USA. dbudenz@bpei.med.miami.edu
Pyfer
M
M
Singh
K
K
Gordon
J
J
Piltz-Seymour
J
J
Keates
E U
EU
D000368:Aged; D002386:Cataract / Q000150:complications; D017024:Chemotherapy, Adjuvant; D005355:Fibrosis / Q000188:drug therapy; D005472:Fluorouracil / Q000008:administration & dosage / Q000627:therapeutic use*; D005901:Glaucoma / Q000150:complications / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure; D007432:Intraoperative Period; D019654:Lens Implantation, Intraocular; D016685:Mitomycin / Q000008:administration & dosage / Q000627:therapeutic use*; D009883:Ophthalmic Solutions; D018918:Phacoemulsification; D012189:Retrospective Studies; D014130:Trabeculectomy; D016896:Treatment Outcome; D014792:Visual Acuity
D009883:Ophthalmic Solutions; D016685:Mitomycin; D005472:Fluorouracil