TRABECULECTOMY WITH INTRAOPERATIVE 5-FLUOROURACIL

BACKGROUND AND OBJECTIVE: To investigate the outcome and complication rates of trabeculectomy following the combined use of intraoperative, topical 5-fluorouracil (5-FU) and low-dose, postoperative subconjuncti val 5-FU injections. PATIENTS AND METHODS: Forty-one eyes of 41 patien ts with advanced, medically uncontrolled glaucoma underwent trabeculec tomy with intraoperative episcleral application of 5-FU (50 mg/ml for 5 minutes). A variable number of subconjunctival 5-FU injections were administered postoperatively at the discretion of the operating surgeo n. RESULTS: Six-, 12-, and 15-month Life-table success rates (5 mm Hg less than or equal to intraocular pressure [IOP less than or equal to 21 mm Hg) were 100%, 97%, and 83%, respectively. Mean postoperative IO P was 12.1 +/- 4.3 mm Hg. An average of 2.2 +/- 1.6 (range 0 to 7) sup plemental subconjunctival 5-FU injections were administered postoperat ively. Corneal epithelial erosions developed in 7 (17%) of the eyes. F ive of 7 patients who underwent subsequent surgical procedures maintai ned successful control of IOP at an average of 11.0 +/- 4.8 (range 5 t o 16) months after the secondary surgery. CONCLUSION: Trabeculectomy w ith intraoperative 5-FU is effective in controlling IOP while possibly minimizing the need for frequent postoperative injections and the occ urrence of corneal epitheliopathy.