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[Peroperative administration of 5-fluorouracil during trabeculectomy in complicated glaucoma in children]
Insights
Preoperative 5-fluorouracil (5-FU) during glaucoma surgery significantly reduced intraocular pressure in children. This treatment offers a promising option for managing pediatric glaucoma, despite some complications.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Pediatric Glaucoma Management
Context:
- Pediatric glaucoma presents unique challenges due to limited treatment options.
- High-risk glaucoma cases in children often require intensive management strategies.
- Trabeculectomy is a common surgical intervention for glaucoma.
Purpose:
- To evaluate the efficacy and safety of preoperative 5-fluorouracil (5-FU) administration during trabeculectomy in children with high-risk glaucoma.
- To assess the impact of 5-FU on intraocular pressure (IOP) reduction and postoperative outcomes.
Summary:
- This study involved 11 children (mean age 7.3 years) with primary or secondary glaucoma undergoing trabeculectomy.
- A 5-minute preoperative application of 5-fluorouracil (50 mg/ml) was administered.
- Postoperative follow-up (average 8.9 months) showed a mean IOP reduction of 41.6%, with 7 eyes achieving IOP < 21 torr.
Impact:
- 5-fluorouracil demonstrated a promising IOP-lowering effect in pediatric glaucoma patients.
- Potential for 5-FU as an adjunctive therapy to improve surgical outcomes in high-risk pediatric glaucoma.
- Identified postoperative complications including hypotonia, shallow anterior chamber, choroidal ablation, and macular edema.
Abstract:
The authors evaluate the results of preoperative 5-minute administration of 5-fluorouracil (5-FU), 50 mg/ml, during trabeculectomy on 11 high risk eyes of children with primary and secondary glaucoma. The mean age of the patients was 7.3 years, the average follow-up period 8.9 months (6-12 months). The intraocular pressure (i.o.p) of 11 eyes before surgery varied between 23 and 46 torr, average 31.5 torr, after treatment it was 13 to 28 torr, average 18.4 torr. The mean drop of IOP was 41.6%. In 7 eyes during the last assessment of IOP < 21 torr with a drop of more than 30%. The remaining 4 eyes have a was IOP between 25 and 28 torr with a reduction of 19-39%. Serious postoperative complications comprised four times marked hypotonia with a shallow anterior chamber, twice choroidal ablation and once macular oedema associated with transient deterioration of vision. In view of the limited therapeutic possibilities of high risk types of glaucoma in children postoperative administration of 5-FU is a promising alternative for the reduction of IOP.