Intraoperative 5-Fluorouracil administration in trabeculectomy

Area of Science:

• Ophthalmology
• Surgical Innovation
• Glaucoma Management

Background:

• Trabeculectomy is a common glaucoma surgery.
• Managing intraocular pressure (IOP) is crucial for preventing vision loss.
• Optimizing surgical techniques to improve trabeculectomy outcomes is an ongoing area of research.

Purpose of the Study:

• To evaluate the safety and efficacy of intraoperative 5-fluorouracil (5-FU) applied beneath the conjunctival flap during trabeculectomy.
• To assess the success rate and impact on IOP and medication use in glaucoma patients.

Main Methods:

• Prospective case series of 43 consecutive glaucoma patients.
• Trabeculectomy performed with intraoperative topical 5-FU administration.
• Outcomes assessed at 6-month follow-up, defining success as IOP ≤21 mm Hg with ≥20% drop and minimal visual acuity loss.

Main Results:

• Overall success rate was 85.4%.
• Mean IOP decreased from 31.4 to 15.1 mm Hg; mean medication use dropped from 2.8 to 0.4.
• Success rates were 69.2% in high-risk and 92.9% in low-risk eyes. No corneal complications occurred.

Conclusions:

• Intraoperative 5-FU application directly to the trabeculectomy site is a safe and effective glaucoma surgery method.
• It offers a valuable alternative for glaucoma treatment, though success may be lower in high-risk patients.
• The technique demonstrates significant IOP reduction and decreased reliance on glaucoma medications.