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Low-dose 5-fluorouracil and glaucoma filtration surgery
1Department of Ophthalmology, Northwestern University Medical School, Chicago, Ill. 60611.
Ophthalmic Surgery
|May 1, 1989
Summary
A 40-mg dose of subconjunctival 5-fluorouracil after glaucoma surgery is effective for stabilizing intraocular pressure. This lower dose shows comparable success rates to higher doses with potentially fewer complications.
Area of Science:
- Ophthalmology
- Surgical Innovation
Background:
- Glaucoma filtering surgery aims to reduce intraocular pressure.
- Subconjunctival 5-fluorouracil is used to enhance surgical success.
- Higher doses of 5-fluorouracil may increase complications.
Purpose of the Study:
- To evaluate the efficacy and safety of a 40-mg total dose of subconjunctival 5-fluorouracil in glaucoma surgery.
- To compare the success rate of a lower 5-fluorouracil dose with historical higher doses.
Main Methods:
- Sixty-four eyes with poor prognoses underwent glaucoma filtering surgery.
- Postoperative subconjunctival injections of 5-fluorouracil (5 mg daily for 7 days, then 1 week later) were administered.
- Intraocular pressure stabilization was the primary outcome measure.
Main Results:
- 75% of eyes achieved stabilized intraocular pressure (≤21 mm Hg).
- Most treatment failures occurred within 6 months.
- Postoperative complications included corneal epithelial defects (30%) and conjunctival wound leaks (6.3%).
Conclusions:
- A 40-mg total dose of subconjunctival 5-fluorouracil is effective after glaucoma filtering surgery.
- This dose appears to achieve success rates comparable to higher doses.
- Lower doses may reduce the incidence of postoperative complications.