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Abstract #5882 Published in IGR 2-1
Comparison of low-dose intraoperative mitomycin-C versus 5-fluorouracil in primary glaucoma surgery: a pilot study
Vijaya L; Mukhes BN; Shantha B; Ramalingam S; Sathi Devi AVOphthalmic Surgery and Lasers 2000; 31:24-30
BACKGROUND AND OBJECTIVES: This study was undertaken to compare the efficacy and safety of low-dose intraoperative application of mitomycin-C (MMC) with that of 5-fluorouracil (5-FU) in primary trabeculectomy. PATIENTS AND METHODS: A non-randomized prospective study was performed between August 1994 and November 1995. Thirty-two eyes of 16 consecutive patients who underwent trabeculectomy for uncontrolled glaucoma of various causes form the study group. The mean age was 46.8±9.9 years. The first eye received MMC (0.2, 0.4 mg/ml), the fellow eye 5-FU (50 mg/ml), for one minute intraoperatively. Bleb characteristics and intraocular pressure (IOP) control were analyzed. Success of surgery based on IOP control was measured by three different criteria: IOP less than 21 mmHg; IOP less than 21 mmHg with more than 30% reduction; and IOP less than 16 mmHg with more than 30% reduction. RESULTS: Mean preoperative IOP was 31.4±12.7 mmHg in the MMC group and 27.8±8.8 mmHg in the 5-FU group. Mean follow-up in the MMC group was 16.12±8.17 months; in the 5-FU group 13.37±8.19 months. At the last follow-up, all 5-FU blebs were non-ischemic, while four eyes in the MMC group showed non-ischemic blebs, and 12 eyes had ischemic blebs. There was no statistically significant difference between the MMC group and 5-FU group success rates with all three criteria. Success rates were: IOP less than 21 mmHg: 100% in both groups; IOP less than 21 mmHg with more than 30% reduction: MMC group 93.8%, 5-FU group 75%; less than 16 mmHg with more than 30% reduction: MMC group 87.5%, 5-FU group 68.8%. CONCLUSIONS: Low-dose intraoperative MMC and 5-FU can provide control of IOP in primary trabeculectomy, 5-FU group showed more non- ischemic blebs.
Dr. L. Vijaya, Medical Research Foundation, 18 College Road, Chennai 600 006, India
Classification:
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
