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Comparison of phacotrabeculectomy with 5-fluorouracil, mitomycin-C, and without antifibrotic agents
1Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, Philadelphia, USA. dbudenz@bpei.med.miami.edu
Background And Objective:
To evaluate the potential benefits, complications, and prognostic risk factors for failure of phacotrabeculectomy performed with or without 5-fluorouracil (5-FU) and mitomycin-C (MMC).
Patients And Methods:
Retrospective chart review of 78 patients who underwent phacotrabeculectomy during a 2-year period. Patients were divided into 3 groups, those who received 5-FU (N = 28). MMC (N = 29), or no antifibrotic agent (N = 21).
Results:
All 3 groups had statistically significant lower intraocular pressures (IOP) on fewer antiglaucomatous medications at 6-month, 12-month, and last follow-up compared to preoperative levels (P < .05). Intraocular pressures were lower in the group that received MMC compared to the 5-FU group, but not in the group that did not receive antimetabolites, at all time intervals measured (P < .05). Black race was a strong predictor of failure of trabeculectomy (P = 009). No differences in final visual acuity or complications were found between groups.
Conclusions:
Phacotrabeculectomy is effective regardless of antimetabolite use. Race is a strong predictor of failure.