BACKGROUND AND OBJECTIVES: 5-Fluorouracil (5-FU) has been used to impr
ove the outcome of trabeculectomy in high-risk cases, employing a post
operative regimen of subconjunctival injections. In light of recent la
boratory evidence of the use of perioperative exposure to 5-FU, the au
thors investigated the outcome of this approach in their patients. PAT
IENTS AND METHODS: Twenty-three eyes of 21 patients who underwent trab
eculectomy with a perioperative application of low-dose (25 mg/ml) 5-F
U, with a minimum follow-up of 1 year, were reviewed retrospectively.
RESULTS: At 1 year postoperatively, 15 (65%) of the eyes had an intrao
cular pressure (IOP) of less than 21 mm Hg without treatment and 3 (13
%) of the eyes achieved the same IOP with the same number of or fewer
medications compared with on admission. The outright successful patien
ts had a significantly shorter disease duration than the remaining pat
ients (P < .05), despite having used a similar number of treatments on
admission, and also had a significantly lower mean number of indicati
ons for antimetabolite use (P < .02). Few complications attributable t
o 5-FU were noted. CONCLUSION: This route of administration appears to
be safe and effective in patients requiring trabeculectomy who are no
t at a high risk for failure.