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[Use of 5-fluorouracil in trabeculectomy]
J Novák1, M Hovorková, P Rozsíval
1Ocní klinika FN, Hradec Králové.
Summary
Subconjunctival 5-fluorouracil (5-FU) effectively treated elevated intraocular pressure after glaucoma surgery. This cytostatic agent normalized pressure in 37% of eyes and improved outcomes in 81% with minimal, transient side effects.
Area of Science:
- Ophthalmology
- Pharmacology
Context:
- Glaucoma surgery, specifically trabeculectomy (TE), can lead to complications like filtration vesicle ingrowth or elevated intraocular pressure (IOP).
- 5-fluorouracil (5-FU) is a cytostatic agent currently used in postoperative glaucoma management.
Purpose:
- To evaluate the efficacy and safety of subconjunctival 5-fluorouracil (5-FU) administration in managing postoperative complications following trabeculectomy (TE).
Summary:
- A study involving 158 eyes undergoing TE investigated the use of subconjunctival 5-FU for indications such as filtration vesicle ingrowth or IOP ≥ 20 torr.
- Preventive administration was also performed during TE revisions in 10 eyes.
- Over a two-year follow-up, 37% of eyes achieved normalized IOP (< 16 torr) without further treatment, and 81% achieved IOP < 20 torr with treatment.
Impact:
- Subconjunctival 5-FU demonstrated a favorable safety profile with transient side effects, primarily corneal epithelium erosion.
- The findings suggest that 5-FU is a safe and effective option for managing postoperative scar formation and elevated IOP after glaucoma surgery, allowing for precise dosage.
- This cytostatic agent offers an optimal therapeutic effect for specific indications in glaucoma management.