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Abstract #5703 Published in IGR 2-1
Mitomycin C and 5-fluorouracil antimetabolite therapy for pediatric glaucoma filtration surgery
Snir M; Lusky M; Shalev B; Gaton D; Weinberger DOphthalmic Surgery and Lasers 2000; 31:31-37
PURPOSE: To evaluate the efficacy and safety of augmented trabeculectomy with 5-fluorouracil (5-FU) and mitomycin C (MMC) compared to 5-FU only for the treatment of pediatric glaucoma. PATIENTS AND METHODS: In a prospective randomized clinical trial, eight children (12 eyes) with pediatric glaucoma, either congenital or secondary to: lens aspiration, Sturge-Weber syndrome, or steroids underwent augmented trabeculectomy. Six patients (eight eyes) underwent augmented trabeculectomy with 5-FU plus MMC and two patients (four eyes) underwent augmented trabeculectomy with 5-FU only. MAIN OUTCOME MEASURES: Between-group comparison of postoperative parameters: change in intraocular pressure (IOP), dependence on antiglaucoma medication, number of 5-FU injections, cup-disc ratio, corneal diameter, drug-induced complications. RESULTS: In the 5-FU/MMC group, seven of eight eyes showed good control of postoperative IOP (9-16 mmHg), which was independent of antiglaucoma therapy; only two injections of 5-FU were needed. In contrast, in the 5-FU group, no control of the postoperative IOP (21-23 mmHg) was achieved in four of four eyes, and these patients remained dependent on antiglaucoma medication; up to six injections of 5-FU were used. There was no deterioration in the cup-disc ratio or the corneal diameter in either group. Results were maintained on follow-up (23-27 months). No significant drug-induced complications were noted. CONCLUSIONS: Augmented trabeculectomy with adjunctive 5-FU/MMC may be an option for the control of pediatric glaucoma in patients with a poor surgical prognosis.
Dr. M. Snir, Pediatric Ophthalmology Unit, Schneider Children's Medical Center of Israel, Beilinson Campus, Petah Tiqva 49202, Israel
Classification:
9.1 Developmental glaucomas (Part of: 9 Clinical forms of glaucomas)
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
