Needling with 5-Fluorouracil for the Treatment of Non-Functioning Functioning Filtering Blebs

The functional loss of bleb due to fibrosis after trabeculeetomy is not rare in glaucoma patients but it is possible the restore to function of bleb with simple treatment. The authors reviewed 15 eyes of 14 patients at least 6 months follow up after the needling and 5-FU injection for the non-functioning bleb after trabeculectomy, in terms of intraocular pressure control and complication. After needling of the non-functioning bleb, 5-FU was used 2mg dosage at one time and average total dosage of 12mg, subconjunctivally. The intraocular pressure was controlled under 21mmHg in 12 of 15 eyes (80%) after this procedure with or without medication. The complication observed is a corneal epithelial defect in 3 of 15 eyes (20%). Therefore, the needling and 5-FU injection for non-functioning bleb after trabeculectomy is recommended before reoperation because it is simple and safe method.

Low-dose 5-Fluorouracil and Glaucoma Filtering Surgery

It has been known that subconjunctival injections of 5-fluorouracil (5-FU) may enhance the surgical outcome of glaucomatous eyes with poor prognosis after filtering surgery. The authors reviewed 24 eyes of 23 patients who had received subconjunctival injections of 5-FU after filtering surgery, and all of them were followed up at least 6 months. The average follow-up period was 12 months, and the average total dosage of 5-FU was 17.4mg per eye. Successful surgical outcomes were observed in 7 of 10 eyes with glaucoma after unsuccessful filtering surgery (70%), 7 of 9 eyes with neovascular glaucoma (78%), and 4 of 5 eyes with aphakic glaucoma (80%). The complications of filtering surgery and 5-FU injections were corneal epithelial defects (17%), hyphema (12%), conjunctival wound leakage (4%), and filtering site obstruction (4%). Therefore, we think that postoperative subconjuntival 5-FU injection increase the success rate of filtering surgery in refractory glaucoma.