Trabeculectomy and the use of Low-dose 5-Fluorouracil

ABSTRACT

5-Fluorouacil (5-FU) 5mg/day was injected subconjunctivally from the third day after trabeculectomy in 8 eyes of 7 patients who had poor prognostic glaucomas such as previously unsuccessful trabeculectomy, aphakic glaucoma, glaucoma after retinal reattachment surgery, and inflammatory glaucoma. The eyes were injected once or multiple times no more than eigth doses in total. Each dose contained 5 mg of 5-FU so patients were given a minimum dosage of 5 mg or an additive maximum dosage of 40 mg. The follow-up period ranged from 2 months to 9 months and averaged 6 months. All eyes showed intraocular pressure below 21 mmHg with or without anti glaucoma medications with the mean intraocular pressure reduced by 16.5 +/- 9.4mmHg from 30.8mmHg preoperatively to 14.3mmHg postoperatively. The postoperative visual acuity was decreased in one eye and remained unchanged in 7 eyes. Diffuse filtering blebs were seen in 7 eyes and an encapsulated bleb was encountered in one eye. The average number of antiglaucoma medications was decreased from 3 preoperativdy to 1.4 postoperatively. Postoperative complications were corneal epithelial detect and conjunctival wound leak in one eye and conjunctival wound leaks alone in two other eyes.