ABSTRACT
Failure of glaucoma filtration surgery usually results from scarring at the surgical site. Studies have shown that fibroblast proliferation plays an important role in scar formation which results in a mechanical barrier to filtration (Gressel, Parris, & Folberg, 1984). Fibroblasts are immature collagen-producing cells which proliferate at the site of chronic inflammation. The antimetabolite 5-fluorouracil (5-FU) can inhibit fibroblast activity. Over the past ten years, the adjunctive use of 5-FU in filtration surgery has met with increased success and is particularly indicated in those patients at greatest risk of filtration failure.
Subject(s)
Fluorouracil/therapeutic use , Glaucoma/drug therapy , Glaucoma/surgery , Aged , Aged, 80 and over , Female , Fibroblasts , Fluorouracil/pharmacology , Follow-Up Studies , Humans , Injections , Male , Middle AgedABSTRACT
Ophthalmologists have been searching for a treatment to control intraocular pressure in difficult cases of glaucoma. The ideal treatment is one that is simple and effective and has few side effects. Transscleral cyclophotocoagulation is less damaging to the ciliary process than cyclocryotherapy in which a probe cooled to -112 degrees F (-80 degrees C) with nitrous oxide gas is applied to the conjunctiva to destruct the ciliary body. Because of the large area that comes in contact with the probe, the patient usually experiences severe pain immediately after surgery. The recent availability of the Nd:YAG lasers with a free-running mode of operation has given physicians a wider range of laser energy and has raised the hope that this treatment technique may be more generally available.
