Intra-operative 5-FU in Glaucoma Surgery: A Nigerian Teaching Hospital Experience

5-Fluorouracil (5-FU) is an anti-metabolite used as an adjunct during the initial stages of a trabeculectomy to prevent excessive post-operative scarring and thus reduce the risk of failure.

To assess the effects of intra-operative 5-FU in trabeculectomy in Nigerians.

Trabeculectomy with an intra-operative sponge soaked with 5-FU was performed in 49 eyes of 34 patients. The reduction in intra-ocular pressure (IOP), Visual acuity changes and complications were noted.

The mean presenting and preoperative IOP was 35.6+/-12.5mmHg and 25.5+/-6.6mmHg respectively. The mean post-operative IOP was 10.0+/- 5.2mmHg on the second post-operative day and 16.5+/7.3mmHg at 3 months. Post-operative complications included ocular hypotony in 4 (25 percent), shallowing of anterior chamber in 3 (18.8 percent), hyphema and cystic bleb in 2 (12.5 percent) each. None had bleb failure. 5 FU appears to reduce the relative risk of failure of trabeculectomy in those undergoing surgery for the first time (relative risk 0.29, 95 percent confidence interval 0.16 to 0.53).

The use of 5-FU during trabeculectomy is associated with significant benefit in terms of intraocular pressure lowering beyond 3 months postoperatively. The results of surgery in Nigerian patients compare well with other reported series.