title: Mitomycin C and 5-fluorouracil antimetabolite therapy for pediatric glaucoma filtration surgery.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of augmented trabeculectomy with 5-fluorouracil (5-FU) and mitomycin C (MMC) compared to 5-FU only for the treatment of pediatric glaucoma.
  
  
  METHODS
  In a prospective randomized clinical trial, 8 children (12 eyes) with pediatric glaucoma, either congenital or secondary to: lens aspiration, Sturge-Weber syndrome, or steroids underwent augmented trabeculectomy. Six patients (8 eyes) underwent augmented trabeculectomy with 5-FU plus MMC and 2 patients (4 eyes) underwent augmented trabeculectomy with 5-FU only.
  
  
  METHODS
  Between-group comparison of postoperative parameters: change in intraocular pressure (IOP), dependence on antiglaucoma medication, number of 5-FU injections, cup-disc ratio, corneal diameter, drug-induced complications.
  
  
  RESULTS
  In the 5-FU/MMC group, 7/8 eyes showed good control of postoperative IOP (9-16 mm Hg), which was independent of antiglaucoma therapy; only 2 injections of 5-FU were needed. By contrast, in the 5-FU group, no control of the postoperative IOP (21-23 mm Hg) was achieved in 4/4 eyes, and these patients remained dependent on antiglaucoma medication; up to 6 injections of 5-FU were used. There was no deterioration in the cup-disc ratio or the corneal diameter in either group. Results were maintained on follow-up (23-27 months). No significant drug-induced complications were noted.
  
  
  CONCLUSIONS
  Augmented trabeculectomy with adjunctive 5-FU/MMC may be an option for the control of pediatric glaucoma in patients with a poor surgical prognosis.
authors.affiliation: Pediatric Ophthalmology Unit, Schneider Children's Medical Center of Israel, Petah Tiqva.
authors.forename: M
authors.initials: M
authors.lastname: Snir
authors.forename: M
authors.initials: M
authors.lastname: Lusky
authors.forename: B
authors.initials: B
authors.lastname: Shalev
authors.forename: D
authors.initials: D
authors.lastname: Gaton
authors.forename: D
authors.initials: D
authors.lastname: Weinberger
mesh_terms: D000477:Alkylating Agents / Q000008:administration & dosage*; D000963:Antimetabolites / Q000008:administration & dosage*; D002675:Child, Preschool; D004333:Drug Administration Routes; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage*; D005901:Glaucoma / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007223:Infant; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D016685:Mitomycin / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D012449:Safety; D014130:Trabeculectomy; D014792:Visual Acuity
chemical_list: D000477:Alkylating Agents; D000963:Antimetabolites; D016685:Mitomycin; D005472:Fluorouracil