RESULTS OF INTRAOPERATIVE 5-FLUOROURACIL OR LOWER DOSE MITOMYCIN-C ADMINISTRATION ON INITIAL TRABECULECTOMY SURGERY

Purpose: This study was conducted to review outcomes in eyes following primary trabeculectomy supplemented intraoperatively with 5-fuorourac il (5-FU) or lower dose mitomycin-C (MMC). Patients and Methods: We re trospectively reviewed the medical records of 73 eyes of 63 patients w ith progressive, far advanced open angle glaucoma who had undergone in itial trabeculectomy with intraoperative application of 5-FU, 50 mg/mL for 5 min (N = 37), or MMC, 200 mu g/mL for 3-5 min (N = 36), and wit h at least 12 months follow-up. Results: Mean preoperative intraocular pressures (IOPs) in the MMC and 5-FU groups were 24.3 +/- 7.6 and 24. 6 +/- 9.3 mm Hg, respectively. Postoperatively, IOPs were similar at B -month interval follow-up examinations in the MMC and 5-FU groups. At an average follow-up of 20.9 months, mean final visit postoperative IO Ps were 10.2 +/- 3.6 (p < 0.001) and 9.7 +/- 3.4 mm Hg (p < 0.001) in the MMC and 5-FU groups, respectively, requiring an average of 0.25 an d 0.22 antiglaucoma medications per eye, respectively. Interval follow up complications were similar between groups and included four bleb le aks in the MMC group, and three bleb leaks in the 5-FU group. Visual a cuity remained stable in 71 of 73 eyes. Conclusions: Both antifibrosis agents provide good intermediate term IOP control and may be appropri ate for use in those eyes requiring final ''target'' IOPs in the low t eens or single digits.