Postoperative 5-fluorouracil versus intraoperative mitomycin C in high-risk glaucoma filtering surgery: extended follow up.
OBJECTIVE
To compare the long-term efficacy and safety of postoperative subconjunctival 5-fluorouracil (5-FU) injections with that of intraoperative mitomycin C (MMC) in eyes at high risk for failure of trabeculectomy.


METHODS
In a retrospective, non-randomized comparative trial, 36 eyes of 36 consecutive patients at high risk for failure of trabeculectomy underwent glaucoma filtering surgery with either postoperative subconjunctival 5-FU injections (19 eyes) or intraoperative application of MMC (17 eyes). Intraocular pressure, number of postoperative antiglaucoma medications, postoperative visual acuity, interventions, and complications were evaluated.


RESULTS
Overall success (intraocular pressure </=21 mmHg) at 1 year was 73.6% in the 5-FU group and 82.3% in the MMC group. The cumulative 4-year success was 52.6% in the 5-FU group and 60.5% in the MMC group (P = 0.6). At 4-year follow up, mean +/- SD intraocular pressures were 17.58 +/- 4.01 mmHg in the 5-FU group and 13.33 +/- 3.36 mmHg in the MMC group (P = 0.01). There was no significant difference in the number of post-operative medications (P = 0.84), appearance of blebs (P = 0.20), final visual acuity (P = 1.00), and complications (P > 0.05) between the groups.


CONCLUSIONS
These results suggest that both postoperative 5-FU injections and intraoperative MMC application have long-term success in high-risk patients. However, MMC results in a greater decrease in intraocular pressure than 5-FU.
Akarsu
Cengiz
C
Department of Ophthalmology, School of Medicine, University of Kirikkale, Kirikkale, Turkey. cengizakarsu@hotmail.com
Onol
Merih
M
Hasanreisoglu
Berati
B
D000328:Adult; D000368:Aged; D005260:Female; D018463:Filtering Surgery / Q000009:adverse effects; D005472:Fluorouracil / Q000627:therapeutic use*; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D011300:Preoperative Care; D012189:Retrospective Studies; D014792:Visual Acuity
D016685:Mitomycin; D005472:Fluorouracil