[Subconjuctival application of 5-fluorouracil (5-FU) following surgical treatment of glaucoma with deep sclerectomy--indications, complications and initial evaluation of effectiveness].
OBJECTIVE
5-FU is an antimetabolite which increases efficacy of deep sclerectomy by inhibiting subconjuctival fibrosis and fibroblast proliferation. The objective of the study was to analyze glaucoma patients who had undergone sclerectomy and in a post-surgery period required subconjuctival 5-FU injections.


METHODS
Out of 120 patients who had undergone deep sclerectomy between January through November 2004, 17 were included in the study since they required subconjuctival 5-FU injections in a post-operative period. The analysis comprised of: (1) indications for antimetabolite administration; (2) time that elapsed from the surgery to the first antimetabolite administration; (3) mean dosage; (4) complications observed; and (5) initial evaluation of the treatment.


RESULTS
In 13 patients (76.4%), the indication for 5-FU application was persistent intraocular pressure exceeding 15 mmHg; in one patient (5.8%), the 5-FU treatment was started due to an abrupt increase of the pressure from hypotony; in 6 subjects (35.2%), it was the thickening and vascular dilatation in the filtering bleb; in one subject (5.8%) encapsulated filtering bleb. Mean time of administering 5-FU was between the 2nd and 3rd week following surgery. Mean number of injections applied was 3.7 (18.5 mg 5-FU). The following complications were encountered: corneal superficial punctuate keratopathy (6 subjects), choroidal detachment (1 person), irregular astigmatism (1 person). In most cases IOP was well controlled by the end of the follow-up period (< or = 15 mmHg).


CONCLUSIONS
5-FU is safe and does not increase the perioperative risk, and has turned out to be effective in most cases of increased scarring in the filtering bleb site.
Wojtulewicz
Małgorzata
M
Z Kliniki Okulistyki Wojskowego Instytutu Medycznego w Warszawie.
Rekas
Marek
M
Wierzbowska
Joanna
J
D000368:Aged; D000369:Aged, 80 and over; D000963:Antimetabolites / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage*; D005901:Glaucoma / Q000188:drug therapy* / Q000601:surgery*; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D012590:Sclera / Q000601:surgery*; D016896:Treatment Outcome
D000963:Antimetabolites; D005472:Fluorouracil