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Related Experiment Videos

Post-operative 5-Fluorouracil for glaucoma surgery.

R Wormald1, M R Wilkins, C Bunce

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

The Cochrane Database of Systematic Reviews
|November 1, 2001
PubMed
Summary

Post-operative 5-Fluorouracil injections may reduce trabeculectomy failure in glaucoma surgery. However, low doses might be ineffective, and while serious complications are not increased, other adverse events are more common.

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Area of Science:

  • Ophthalmology
  • Surgical Innovation
  • Pharmacology

Background:

  • Trabeculectomy is a surgical procedure to reduce intra-ocular pressure in glaucoma.
  • Scar tissue formation can lead to trabeculectomy failure by blocking fluid outflow.
  • Antimetabolites like 5-Fluorouracil (5-FU) are used to inhibit scarring after glaucoma surgery.

Purpose of the Study:

  • To evaluate the effectiveness of post-operative 5-Fluorouracil injections in glaucoma surgery.
  • To assess the impact of 5-FU on preventing surgical failure and complications.

Main Methods:

  • Systematic review of randomized controlled trials comparing post-operative 5-FU injections to placebo or no injections.
  • Searches conducted in CENTRAL, MEDLINE, and EMBASE, with reference list and citation searches.

Related Experiment Videos

  • Data extraction and quality assessment performed independently by two reviewers.
  • Main Results:

    • Nine trials with 614 participants were included; methodological quality was generally low.
    • Post-operative 5-FU injections reduced the likelihood of trabeculectomy failure, especially in high-risk eyes.
    • Low doses of 5-FU may not be effective; other complications increased, though serious sight-threatening ones did not.

    Conclusions:

    • Post-operative 5-FU injections appear effective in preventing trabeculectomy failure but are used less frequently.
    • The increased incidence of non-serious complications may contribute to reduced use.
    • A significant omission in trials was the lack of reporting on patient perspectives regarding this invasive treatment.