5-FU-supplemented phacoemulsification, posterior chamber intraocular lens implantation, and trabeculectomy

I reviewed the charts of 129 consecutive patients: 38 of whom underwent 5-fluorouracil (5-FU)-supplemented, combined phacoemulsification, posterior chamber lens implantation, and trabeculectomy (phaco/5-FU group); 55 of whom underwent the same combined procedure without 5-FU (phaco group); and 36 of whom underwent a similar combined procedure in which extracapsular cataract surgery was performed instead of phacoemulsification, again without 5-FU (ECCE group). I evaluated and compared the surgical results in these three groups at several points, up to and including 1 year postoperatively, in terms of intraocular pressure (IOP), number of antiglaucoma medications being used, presence or absence of a visible filtering bleb, visual field, anterior chamber cell and flare, visual acuity, postoperative induced astigmatism, and incidence of cystoid macular edema. At 3 months and beyond, there were more blebs in the phaco/5-FU group than in the phaco or ECCE groups. IOPs were generally lowest in the phaco/5-FU group, as were the number of antiglaucoma medications being used. There was no significant difference in the distribution of the amount of visual field loss among the three groups. Inflammation was generally least in the phaco/5-FU group, but there was no significant difference among the groups in terms of postoperative-induced astigmatism and visual acuity. I conclude that 5-FU-supplemented phacoemulsification combined surgery is safe and probably produces better filtering results than those achieved without the adjunctive use of 5-FU.