Abstract
Purpose To study the efficacy of the adjunctive use of a single intraoperative application of 5-fluorouracil (5FU) in eyes with poor prognoses for a successful outcome with a trabeculectomy.
Method Twenty-four patients (25 eyes) with a mean age of 63.7 ± 14.7 years (range 27-86 years) and a history of one or more risk factors (age <50 years, more than 3 years on topical medication, a previous failed filter, previous cataract surgery, uveitis, neovascular glaucoma) underwent trabeculectomy with the intraoperative application of 5FU on a sponge (25 mg/ml) for 5 min. The average follow-up was 10.1 ± 5.5 months.
Results The mean pre-operative intraocular pressure (IOP) was 24.7 ± 6.2 mmHg and the mean post-operative IOP was 13.9 ± 3.5 mmHg. Success, defined as an IOP within desired target levels for a particular eye, in the presence of a functioning filter, without supplementary medical therapy, was achieved in 56.5% of cases.
Conclusions Our results of successful filters in this group of patients with moderate- to high-risk characteristics approach similar figures quoted for trabeculectomies without the adjunctive use of intraoperative 5FU in eyes with poor prognoses with a similar length of follow-up. Though the numbers are small there is a trend that indicates that the intraoperative application of a single dose of 5 FU alone may not be sufficient in eyes with moderate- to high-risk characteristics of failure of a trabeculectomy.
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Watts, P., Karia, N. & McAllister, J. Is the single use of intraoperative 5-fluorouracil in filtering surgery for high-risk cases enough?. Eye 12, 374–378 (1998). https://doi.org/10.1038/eye.1998.89
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DOI: https://doi.org/10.1038/eye.1998.89
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