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Abstract #18283 Published in IGR 3-3
The efficacy and safety of intraoperative and/or postoperative 5-fluorouracil in trabeculectomy and phacotrabeculectomy
Singh RP; Goldberg I; Mohsin MClinical and Experimental Ophthalmology 2001; 29:296-302
PURPOSE: Firstly, to assess the safety and efficacy of using 5-fluorouracil (5-FU) to improve trabeculectomy and phacotrabeculectomy success rates, and secondly, to assess the efficacy of intraoperative and reduced postoperative 5-FU following trabeculectomy compared with a more intensive course of postoperative 5-FU alone. METHODS: In a retrospective, unmatched, non-randomized consecutive series study, 186 eyes of 186 patients who had filtration surgery were followed for two years in four groups: 51 patients had undergone trabeculectomy surgery with postoperative 5-FU, 51 had phacotrabeculectomy with postoperative 5-FU, 56 had trabeculectomy with both intraoperative and postoperative 5-FU, and 28 patients had trabeculectomy without antifibrotics. RESULTS: At all times mean intraocular pressure (IOP) was reduced n all groups (p < 0.001 for each group). Success was defined as IOP <16 mmHg and >30% IOP reduction at the two-year follow up. This was achieved in 71% of the trabeculectomy patients with intraoperative and postoperative 5-FU, 76% of the trabeculectomy group with only postoperative 5-FU, 55% of the phacotrabeculectomy/5-FU group, and in 29% of the trabeculectomy-only eyes (between-group differences p < 0.01). Success rates were not significantly different for the intraoperative and postoperative 5-FU trabeculectomy versus the postoperative 5-FU-only eyes, but the former had fewer postoperative 5-FU injections and corneal ulceration (p < 0.01 for both). CONCLUSIONS: 5-Fluorouracil was safe and improved trabeculectomy survival. Intraoperative 5-FU allowed fewer postoperative 5-FU injections and fewer side-effects without compromising success rates. Phacotrabeculectomy with postoperative 5-FU had a lower surgical success rate than did trabeculectomy with 5-FU and this was not statistically different from trabeculectomy without 5-FU.
Dr R.P. Singh, Eye Associates, Sydney, New South Wales, Australia
Classification:
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
