title: Effect of mitomycin c and 5-flurouracil adjuvant therapy on the outcomes of Ahmed glaucoma valve implantation.
abstract: BACKGROUND
  To examine the effect of mitomycin c and 5-flurouracil on treatment outcomes following Ahmed glaucoma valve implantation.
  
  
  METHODS
  Retrospective consecutive case series.
  
  
  METHODS
  Fifty patients who received Ahmed glaucoma valve implantation from 1999 to 2013 in the San Francisco Veterans Administration Hospital.
  
  
  METHODS
  The +INJECTION group received intraoperative mitomycin c followed by postoperative mitomycin c and/or 5-flurouracil, whereas the -INJECTION group did not.
  
  
  METHODS
  Primary outcome was treatment success at 1 year post-implantation. Intraocular pressure, hypertensive phase, and the number of glaucoma medications were also examined.
  
  
  RESULTS
  Twenty-six patients/eyes in the +INJECTION group and 24 patients/eyes in the -INJECTION group were included. Treatment success was higher in the +INJECTION compared with the -INJECTION group (86 vs. 58%; P = 0.04). Intraocular pressure was lower in the +INJECTION compared with the -INJECTION group at 1, 3, 6 and 12 months (P ≪ 0.00001, P = 0.00003, 0.0008 and 0.024). Hypertensive phase occurred less often in the +INJECTION compared with the -INJECTION group (3.8 vs. 54%; P = 0.021). The +INJECTION group required fewer medications compared with the -INJECTION group (P = 0.02, 0.002, 0.003 and 0.008 at 1, 3, 6 and 12 months). Complication rates were comparable between groups (46.2 and 54.2%; P = 0.63).
  
  
  CONCLUSIONS
  Adjuvant treatment with antifibrotics following Ahmed glaucoma valve implantation decreased the hypertensive phase and improved surgical outcomes without impacting complication rates at 1 year. This study postulates a role for antifibrotics in the postoperative management of Ahmed glaucoma valves.
authors.affiliation: Department of Ophthalmology, University of California, San Francisco, California, USA.
authors.forename: Qi N
authors.identifier: http://orcid.org/0000-0002-5338-0401
authors.initials: QN
authors.lastname: Cui
authors.affiliation: Department of Ophthalmology, University of California, San Francisco, California, USA.
authors.forename: Yen C
authors.initials: YC
authors.lastname: Hsia
authors.affiliation: Department of Ophthalmology, University of California, San Francisco, California, USA.
authors.forename: Shan C
authors.initials: SC
authors.lastname: Lin
authors.affiliation: Department of Ophthalmology, University of California, San Francisco, California, USA.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Stamper
authors.affiliation: Department of Ophthalmology, University of California, San Francisco, California, USA.|Francis I. Proctor Foundation, University of California, San Francisco, California, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Rose-Nussbaumer
authors.affiliation: Department of Ophthalmology, University of California, San Francisco, California, USA.
authors.forename: Nitisha
authors.initials: N
authors.lastname: Mehta
authors.affiliation: Department of Ophthalmology, University of California, San Francisco, California, USA.|Francis I. Proctor Foundation, University of California, San Francisco, California, USA.|Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA.
authors.forename: Travis C
authors.initials: TC
authors.lastname: Porco
authors.affiliation: Department of Ophthalmology, University of California, San Francisco, California, USA.|San Francisco Veterans Administration Hospital, San Francisco, California, USA.
authors.forename: Ayman
authors.initials: A
authors.lastname: Naseri
authors.affiliation: Department of Ophthalmology, University of California, San Francisco, California, USA.|San Francisco Veterans Administration Hospital, San Francisco, California, USA.
authors.forename: Ying
authors.initials: Y
authors.lastname: Han
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005472:Fluorouracil / Q000008:administration & dosage*; D005500:Follow-Up Studies; D005901:Glaucoma / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007267:Injections; D007429:Intraocular Pressure / Q000502:physiology*; D007432:Intraoperative Period; D008297:Male; D016685:Mitomycin / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000517:prevention & control*; D011184:Postoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000903:Antibiotics, Antineoplastic; D007166:Immunosuppressive Agents; D016685:Mitomycin; D005472:Fluorouracil
keywords: glaucoma; glaucoma drainage implants; intraocular pressure; treatment outcome; wound healing