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Related Experiment Videos

Trabeculectomy with intraoperative 5-fluorouracil

P A Sidoti1, J C Choi, E N Morinelli

  • 1University of Southern California School of Medicine, Los Angeles, USA.

Ophthalmic Surgery and Lasers
|July 23, 1998
PubMed
Summary

Trabeculectomy using intraoperative 5-fluorouracil (5-FU) effectively controlled glaucoma, reducing the need for frequent postoperative injections and minimizing corneal issues. This approach demonstrated high success rates in maintaining target intraocular pressure.

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Area of Science:

  • Ophthalmology
  • Glaucoma Surgery
  • Pharmacological Adjuncts

Background:

  • Trabeculectomy is a primary surgical treatment for advanced glaucoma.
  • Managing intraocular pressure (IOP) post-trabeculectomy often requires adjunctive therapies.
  • 5-fluorouracil (5-FU) is used to modulate healing and prevent scarring after glaucoma surgery.

Purpose of the Study:

  • To evaluate the efficacy and safety of combining intraoperative topical 5-fluorouracil (5-FU) with postoperative subconjunctival 5-FU injections.
  • To assess the outcome and complication rates of this combined 5-FU regimen in trabeculectomy.
  • To determine the impact on intraocular pressure control and the need for further interventions.

Main Methods:

  • A cohort of 41 patients with advanced, medically uncontrolled glaucoma underwent trabeculectomy.

Related Experiment Videos

  • Intraoperative episcleral 5-FU application (50 mg/ml for 5 minutes) was performed.
  • Postoperative subconjunctival 5-FU injections were administered at the surgeon's discretion.

    • Main Results:

    • Six-, 12-, and 15-month success rates (IOP ≤ 21 mm Hg) were 100%, 97%, and 83%, respectively.
    • Mean postoperative IOP was 12.1 ± 4.3 mm Hg.
    • Corneal epithelial erosions occurred in 17% of eyes; 5 of 7 patients with subsequent procedures maintained IOP control.

    Conclusions:

    • Trabeculectomy combined with intraoperative 5-FU is an effective strategy for IOP control in advanced glaucoma.
    • This approach may reduce the requirement for frequent postoperative 5-FU injections.
    • The combined regimen appears to minimize the incidence of corneal epitheliopathy compared to other methods.