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Filtering surgery with 5-fluorouracil subsequent to Molteno implant
Israel Journal of Medical Sciences
|November 1, 1993
Summary
Filtering surgery with 5-fluorouracil (5-FU) shows promise for refractory glaucoma after Molteno shunt failure. This approach may offer an effective surgical option for patients with non-neovascular glaucoma.
Area of Science:
- Ophthalmology
- Surgical Innovation
Background:
- Refractory glaucoma management remains challenging, especially after Molteno shunt implantation failure.
- Optimal surgical strategies for recurrent or persistent elevated intraocular pressure post-shunt are not well-defined.
Purpose of the Study:
- To evaluate the efficacy of filtering surgery augmented with 5-fluorouracil (5-FU) in eyes with refractory non-neovascular glaucoma following failed Molteno shunt implantation.
Main Methods:
- Four patients with non-neovascular refractory glaucoma underwent filtering surgery with adjunctive 5-FU injections (5 mg daily for 9-14 days).
- Intraocular pressure (IOP) was monitored post-operatively.
- One patient required a repeat procedure due to bleb scarring.
Main Results:
- In three eyes, IOP ranged from 10-16 mm Hg after 6-18 months of follow-up.
- The fourth eye, initially showing bleb scarring, achieved successful IOP control after a second filtering surgery with 5-FU, with outcomes assessed up to 26 months later.
Conclusions:
- Filtering surgery with 5-FU appears to be a viable and potentially successful surgical option for managing refractory non-neovascular glaucoma after Molteno shunt failure.
- Further studies are warranted to confirm these preliminary findings and establish 5-FU augmented filtering surgery as a standard treatment option.