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Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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Related Experiment Video

Updated: May 2, 2026

Ultrasound Cyclo Plasty in Eyes with Glaucoma
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5-Fluorouracil for glaucoma surgery.

Elspeth Green1, Mark Wilkins, Catey Bunce

  • 1Norfolk and Norwich University Hospital, Colney Lane, Norwich, UK, NR4 7UY.

The Cochrane Database of Systematic Reviews
|February 21, 2014
PubMed
Summary
This summary is machine-generated.

5-Fluorouracil (5-FU) injections after glaucoma surgery significantly reduce surgical failure and intraocular pressure in high-risk patients. However, this benefit must be balanced against increased complications and patient preference.

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Area of Science:

  • Ophthalmology
  • Surgical Innovation
  • Pharmacological Intervention

Background:

  • Trabeculectomy is a glaucoma surgery to reduce intraocular pressure by creating a fluid drainage channel.
  • Scar tissue formation can obstruct this channel, leading to surgical failure.
  • 5-Fluorouracil (5-FU) is an antimetabolite used to inhibit wound healing and prevent scarring after trabeculectomy.

Purpose of the Study:

  • To evaluate the one-year efficacy of intraoperative and postoperative 5-Fluorouracil (5-FU) in glaucoma surgery.
  • To assess the impact of 5-FU on surgical failure rates and intraocular pressure.

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials comparing 5-FU with placebo or no treatment.
  • Searches included multiple databases up to July 2013.
  • Data were analyzed for subgroups including risk of failure, combined surgery, and primary trabeculectomy, with 5-FU interventions categorized as intraoperative, regular dose postoperative, and low dose postoperative.

Main Results:

  • Regular-dose postoperative 5-FU significantly reduced surgical failure in high-risk and primary trabeculectomy groups (RR 0.44 and 0.21).
  • Intraoperative 5-FU also reduced failure risk in primary trabeculectomy (RR 0.67).
  • Significant intraocular pressure reduction was observed with intraoperative and regular-dose postoperative 5-FU, particularly in high-risk patients (MD -16.30).
  • Increased complications were noted with 5-FU injections, though serious sight-threatening complications were not evident.

Conclusions:

  • Regular-dose postoperative 5-FU demonstrates a statistically significant reduction in surgical failures and intraocular pressure for specific glaucoma surgery patient groups.
  • The benefits must be weighed against potential complications and patient acceptance, as 5-FU injections are now less common in routine care.
  • A significant omission in the reviewed trials was the lack of reporting on patient perspectives regarding the treatment.