Trabeculectomy with intraoperative sponge 5-fluorouracil

Area of Science:

• Ophthalmology
• Surgical Innovation

Background:

• Glaucoma management often requires surgical intervention to reduce intraocular pressure (IOP).
• Trabeculectomy is a common surgical procedure for glaucoma, but its success can be enhanced with adjunct therapies.
• 5-fluorouracil (5-FU) is a chemotherapeutic agent used to modulate wound healing and prevent scarring in ocular surgery.

Purpose of the Study:

• To evaluate the efficacy and safety of using intraoperative 5-fluorouracil (5-FU) sponge during trabeculectomy.
• To assess the impact of 5-FU on intraocular pressure reduction and the need for postoperative glaucoma medications.

Main Methods:

• A retrospective analysis of 140 eyes from 119 patients who underwent trabeculectomy with intraoperative 5-FU sponge.
• Data collected included preoperative and postoperative intraocular pressure (IOP), number of supplementary injections, and complications.
• Patients were categorized into low- and high-risk groups to assess differences in outcomes.

Main Results:

• Mean preoperative IOP of 25.7 mmHg decreased to 12.5 mmHg postoperatively, a 52% reduction (P < 0.0001).
• 86.4% of eyes achieved target IOP without postoperative glaucoma medications; mean medication use dropped significantly (P < 0.001).
• Corneal epithelial damage occurred in 37% of eyes, correlating with postoperative 5-FU supplementation.

Conclusions:

• Intraoperative 5-FU sponge is a safe and effective adjunct to trabeculectomy.
• The procedure significantly reduces IOP and the need for glaucoma medications.
• While generally safe, potential complications like corneal damage warrant consideration, especially with supplementary 5-FU use.