Intraocular pressure outcome in primary 5FU phacotrabeculectomies compared with 5FU trabeculectomies.
OBJECTIVE
Combined surgery for glaucoma and cataract may not achieve as low intraocular pressure (IOP) as compared with trabeculectomy alone. The aim of this study was to assess the IOP control of 5-fluorouracil (5FU) phacotrabeculectomies compared with 5-fluorouracil trabeculectomies.


METHODS
A retrospective, nonrandomized study of consecutive primary 5FU phacotrabeculectomies and primary 5FU trabeculectomies. The main outcome measures were preoperative and postoperative IOP, number of medications, visual acuity, and complications.


RESULTS
Forty-five 5FU phacotrabeculectomies and 47 5FU trabeculectomies were performed with a mean follow-up of 43.1 and 36.6 months, respectively. The absolute success rate as defined as an IOP equal to or less than 16 mm Hg on no glaucoma drops was 62.2% for the phacotrabeculectomy group and 63.8% for the trabeculectomy group. These success rates were not statistically significantly different (log-rank test P = 0.81 for absolute success and P = 0.29 for relative success). The magnitude of the treatment effect was found to be significantly greater in the T group compared with the PT group (a 44.6% reduction in IOP in the T group compared with a 31.2% reduction in the PT group). The phacotrabectomy group underwent significantly more postoperative 5FU injections compared with the trabeculectomy group (P = 0.008).


CONCLUSIONS
5FU phacotrabeculectomy seems to be a safe and effective treatment option in terms of IOP control. Patients with both coexistent glaucoma and cataract could be considered for combined surgery.
Chang
Lydia
L
Hillingdon Hospital NHS Trust, London, UK.
Thiagarajan
Manickam
M
Moseley
Merrick
M
Woodruff
Simon
S
Bentley
Chris
C
Khaw
Peng Tee
PT
Bloom
Philip
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D002386:Cataract / Q000150:complications / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage*; D005901:Glaucoma / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D012189:Retrospective Studies; D014130:Trabeculectomy / Q000379:methods*; D014792:Visual Acuity
D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil