LOW-DOSE PERIOPERATIVE 5-FLUOROURACIL IN TRABECULECTOMY

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.