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Abstract #22222 Published in IGR 10-4
Long-term comparison of primary trabeculectomy with 5-fluorouracil versus mitomycin C in West Africa
Kim HY; Egbert PR; Singh KJournal of Glaucoma 2008; 17: 578-583
See also comment(s) by Keith Barton •
PURPOSE: To compare the long-term efficacy and safety of intraoperative 5-fluorouracil (5-FU) versus mitomycin-C (MMC) used adjunctively with primary trabeculectomy in a Black West African population. DESIGN: Retrospective comparative study supplemented with cross-sectional follow-up data. METHODS: Review of 68 eyes of 68 Black West African subjects that underwent primary trabeculectomy with the use of intraoperative 5-FU or MMC between January 1, 1988 and January 1, 2002 and had at least 3 years postoperative follow-up. Postoperative outcome measures included intraocular pressure (IOP) control, number of glaucoma medications, visual acuity, and complications. RESULTS: Thirty-eight of sixty-eight eyes received 5-FU and 30 received MMC. Mean postoperative follow-up was 7.5 and 6.5 years in the 5-FU and MMC groups, respectively (P = 0.17). A higher proportion of eyes in the MMC group achieved 'qualified' (with or without medical therapy) success with varying IOP targets relative to the 5-FU group, but the differences were not statistically significant. 'Complete' (without medical therapy) postoperative success was greater in the MMC group with a significantly higher proportion achieving an IOP < 21 mmHg (P = 0.02). MMC use was also associated with a lower likelihood of receiving IOP-lowering medications postoperatively (P = 0.01). Baseline demographic characteristics, preoperative and postoperative IOP, visual acuity, and complications did not differ significantly between the two groups. CONCLUSIONS: Intraoperative MMC use is associated with a lower likelihood of requiring postoperative medications and a greater likelihood of achieving IOP lowering without medications relative to the use of 5-FU in a Black West African population.
Dr. H.Y. Kim, Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA 97303, USA. hannakim@stanford.edu
