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Related Experiment Videos

Post-operative 5-fluorouracil for glaucoma surgery.

R Wormald1, M R Wilkins, C Bunce

  • 1'Glaxo' Department of Ophthalmic Epidemiology, Institute of Ophthalmology (UCL) and Moorfields Eye Hospital, City Road, London, UK, EC1V 2PD. r.wormald@ucl.ac.uk

The Cochrane Database of Systematic Reviews
|May 5, 2000
PubMed
Summary
This summary is machine-generated.

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Post-operative 5-Fluorouracil injections may reduce glaucoma surgery failure but increase complications like wound leaks and hypotony. This treatment is now rarely used as a planned series due to patient and doctor concerns.

Area of Science:

  • Ophthalmology
  • Surgical Innovation
  • Glaucoma Treatment

Background:

  • Trabeculectomy surgery aims to lower intra-ocular pressure in glaucoma by creating a fluid drainage channel.
  • Scar tissue formation can block this channel, leading to surgical failure.
  • Antimetabolites like 5-Fluorouracil (5-FU) inhibit scarring, with topical application during surgery and post-operative injections as potential methods.

Purpose of the Study:

  • To assess the efficacy and safety of post-operative 5-Fluorouracil injections following trabeculectomy for glaucoma.

Main Methods:

  • Systematic review of randomized controlled trials comparing post-operative 5-FU injections to placebo or no injections.
  • Searches included major databases (Cochrane, MEDLINE, EMBASE) and citation tracking.
  • Data extraction and quality assessment were performed independently.

Related Experiment Videos

Main Results:

  • Eight trials with 536 participants indicated that post-operative 5-FU injections reduce trabeculectomy failure, particularly in high-risk eyes.
  • Complications such as wound leaks and ocular surface damage were more frequent.
  • A significant increased risk of ocular hypotony was observed in patients undergoing initial trabeculectomy.

Conclusions:

  • Post-operative 5-FU injections are effective in preventing glaucoma surgery failure but are associated with increased complications.
  • The planned use of this treatment is now uncommon, likely due to patient and physician concerns.
  • The effectiveness of ad hoc injection strategies requires further investigation.