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Abstract #15584 Published in IGR 1-3
Use of 'low dose' 5-fluorouracil during trabeculectomy
Detry-Morel M; Kolanowski CBulletin de la Société Belge d'Ophtalmologie 1999; 272: 33-42
PURPOSE: This retrospective study was undertaken to evaluate whether a 'low dose' intraoperative sponge 5-fluorouracil application would improve the quality of the postoperative IOP control without increasing the incidence of postoperative complications following a first trabeculectomy in low-risk and/or severe field defects glaucomatous patients compared to a control group. MATERIAL-METHOD: The study included a total of 41 trabeculectomies performed in 39 patients. An intraoperative sponge 5-FU application (10 mg/ml) was performed during a mean duration of one minute in 28 trabeculectomies. Mean follow-up was 10.1 ± 5.6 months (range, 3-24 months) and was comparable in 5-FU and control group. Mean age of the patients (62.9 ± 11.4 years) was not significantly different in either group, nor was as their preoperative mean visual acuity, the severity of their visual field defects, the importance, nature of preoperative topical medications and number of sutures in scleral flap during trabeculectomy. Only the thickness of Tenon's capsule was significantly different between the two groups (p < 0.05). These success criteria were based on a 'target' IOP reached at the last examination, with or without adjunctive medical treatment. RESULTS: Mean preoperative IOP was 32.2 ± 8.4 mmHg and was reduced in the last control to a mean value of 14.4 ± 4.0 mmHg without any significant difference between the 5-FU group and the control group (p>0.05). The rate of failures was higher in the control group (15.3%) than in the 5-FU group (7.1%) at the last examination. Significantly more eyes (31%) in the control group required adjunctive postoperative medication than in the 5-FU group (3%) at the last follow-up. The incidence and severity of complications were not significantly different between the groups. Postoperative 5-FU injections were performed in a nonsignificantly different number of eyes in one group compared to the other. Morphological characteristics of filtration blebs were comparable between the groups. CONCLUSIONS: A 'low dose' intraoperative 5-FU sponge application during a first trabeculectomy in low-risk patients and/or in patients with severe field defects in whom a low-ten target IOP is mandatory, seems to improve the postoperative IOP control without increasing the incidence of postoperative complications.
Dr. M. Detry-Morel, Cliniques Universitaires St. Luc, UCL, Brussels; Belgium
Classification:
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)