A randomised trial of the effect of intraoperative 5-FU on the outcome of trabeculectomy in east Africa.
OBJECTIVE
To determine if intraoperative application of 5-fluorouracil (5-FU) improves the prognosis for trabeculectomy in east Africa.


METHODS
68 eyes with chronic open angle glaucoma were included in a randomised trial of intraoperative 5-FU versus placebo. Main outcome measures were intraocular pressures at 6 months and probability of failure at 2 years.


RESULTS
180 days after surgery the mean intraocular pressure (IOP) was 17.4 (SD 6.1) mm Hg in the placebo group and 16.9 (5.8) mm Hg in the 5-FU group. By 2 years after trabeculectomy, the probability of successful IOP control was 70.6% in the placebo group, and 88.8% in the 5-FU group. The placebo group was 2.18 times (95% CI 0.67 to 7.15) more likely to require additional IOP lowering procedures than the 5-FU group. Among patients followed for 2 years, 30% lost 0.3 logMAR units of visual acuity.


CONCLUSIONS
Trabeculectomy in Africa has an acceptable success rate which may be enhanced by the use of intraoperative 5-FU. It is estimated that this would cost approximately 1.25 pounds sterling per trabeculectomy failure prevented.
Yorston
D
D
Kikuyu Eye Unit, Kikuyu, Kenya. e.cartwright@ucl.ac.uk
Khaw
P T
PT
D000963:Antimetabolites / Q000627:therapeutic use*; D002908:Chronic Disease; D005472:Fluorouracil / Q000627:therapeutic use*; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D007430:Intraoperative Care / Q000379:methods*; D011379:Prognosis; D014130:Trabeculectomy; D017211:Treatment Failure; D016896:Treatment Outcome
D000963:Antimetabolites; D005472:Fluorouracil