Low-dose 5-fluorouracil and glaucoma filtration surgery

We show that a 40-mg total dose of subconjunctival 5-fluorouracil after glaucoma filtering surgery can provide a success rate comparable to that demonstrated in prior studies employing a higher dose. Sixty-four eyes with poor prognoses underwent filtering surgery with postoperative subconjunctival injections of 5 mg of 5-fluorouracil daily for seven days followed by one injection 1 week later. In 75% percent of the eyes intraocular pressure stabilized at 21 mm Hg or less regardless of medications used. The majority of failures occurred within 6 months of treatment. Postoperative corneal epithelial defects occurred in 30% of the cases, conjunctival wound leaks in 6.3%. A 40-mg dose of subconjunctival 5-fluorouracil appears to be effective and may be associated with a lower incidence of postoperative complications than higher doses.