Ultrasound biomicroscopy in nonperforating filtering surgery with intraoperative 5-fluorouracil and no implant: long-term results.
OBJECTIVE
To evaluate the long-term morphologic changes in the anterior segment structures after nonpenetrating filtering surgery (NPFS) supplemented with 5-fluorouracil (5-FU) and no scleral implant using ultrasound biomicroscopy (UBM).


METHODS
Thirteen eyes of 13 consecutive patients who underwent NPFS with intraoperative 5-FU under the conjunctiva and the scleral flap and no implant were evaluated in an observational nonrandomized, consecutive case series study conducted 2 years postoperatively. Patients were assessed for the presence of a subconjunctival filtering bleb, the volume of an intrascleral cavity, and a suprachoroidal hypoechoic area. The intraocular pressure(IOP) was measured preoperatively and postoperatively at the time of UBM.


RESULTS
The IOP decreased significantly (p=0.01) from 24-/+7.6 mmHg to 13.7-/+4.1 mmHg. In most patients (69.2%), the postoperative IOP decreased at least 30% from the preoperative value without medications and in 84.6% with medication. UBM showed a subconjunctival empty space in 92.3% of eyes. In 84.6% of patients, an intrascleral cavity was seen, the mean volume of which was 1.68 mm(3) (range, 0-4.07). We found a negative correlation between the height, width, and volume of the intrascleral lake and the IOP. In 92.3% of eyes, a hypoechoic area in the suprachoroidal space also was seen.


CONCLUSIONS
UBM showed a filtering intrascleral cavity, subconjunctival filtering bleb, and a suprachoroidal space after NPFS supplemented with 5-FU under the conjunctiva and the scleral flap without an implant.
Gutiérrez-Ortiz
Consuelo
C
Hospital Universitario Príncipe de Asturias, Madrid - Spain. consuelogutierre@hotmail.com
Vleming
Eduardo
E
Pareja
Jesus
J
Teus
Miguel A
MA
D000368:Aged; D000369:Aged, 80 and over; D000869:Anterior Eye Segment / Q000000981:diagnostic imaging* / Q000601:surgery; D000963:Antimetabolites / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D005260:Female; D018463:Filtering Surgery; D005472:Fluorouracil / Q000008:administration & dosage*; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D033401:Microscopy, Acoustic; D008875:Middle Aged; D013524:Surgical Flaps; D014792:Visual Acuity
D000963:Antimetabolites; D005472:Fluorouracil