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Persistent Corneal Edema Associated With Subconjunctival 5-fluorouracil in an Infant With Primary Congenital Glaucoma

Gregory L Fu, Janet L Alexander, Osamah J Saeedi

    Journal of Pediatric Ophthalmology and Strabismus
    |October 27, 2016
    PubMed

    Insights

    A rare corneal opacity occurred in an infant treated for congenital glaucoma with 5-fluorouracil. This transient toxicity, though temporary, poses a risk for amblyopia, highlighting the need for careful monitoring.

    Area of Science:

    • Ophthalmology
    • Pediatric Ophthalmology
    • Glaucoma Management

    Background:

    • Primary congenital glaucoma requires surgical intervention.
    • Needle bleb revision with 5-fluorouracil is a treatment option.
    • Corneal complications can arise from glaucoma surgery.

    Observation:

    • A 3-month-old boy with congenital glaucoma underwent needle bleb revision.
    • Adjunctive 5-fluorouracil was used during the procedure.
    • Transient corneal endothelial opacity developed post-operatively.

    Findings:

    • The case demonstrates a rare instance of corneal endothelial toxicity from 5-fluorouracil.
    • The opacity was transient but concerning for potential amblyopia.
    • Prior literature on 5-fluorouracil-induced corneal opacity was reviewed.

    Implications:

    • This adverse event underscores the potential risks of antimetabolites in pediatric glaucoma.
    • Close monitoring for visual development is crucial in affected infants.
    • Further research may be warranted to optimize safety profiles of adjunctive therapies.

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