IS THE SINGLE-USE OF INTRAOPERATIVE 5-FLUOROURACIL IN FILTERING SURGERY FOR HIGH-RISK CASES ENOUGH

Purpose To study the efficacy of the adjunctive use of a single intrao perative application of Ei-fluorouracil (5FU) in eyes with poor progno ses for a successful outcome with a trabeculectomy. Method Twenty-four patients (25 eyes) with a mean age of 63.7 +/- 14.7 years (range 27-8 6 years) and a history of one or more risk factors (age <50 years, mor e than 3 years on topical medication, a previous failed filter, previo us cataract surgery, uveitis, neovascular glaucoma) underwent trabecul ectomy with the intraoperative application of 5FU on a sponge (25 mg/m l) for 5 min. The average follow-up was 10.1 +/- 5.5 months. Results T he mean pre-operative intraocular pressure (IOP) was 24.7 +/- 6.2 mmHg and the mean post-operative IOP was 13.9 +/- 3.5 mmHg. Success, defin ed as an IOP within desired target levels for a particular eye, in the presence of a functioning filter, without supplementary medical thera py, was achieved in 56.5% of cases. Conclusions Our results of success ful filters in this group of patients with moderate- to highrisk chara cteristics approach similar figures quoted for trabeculectomies withou t the adjunctive use of intraoperative 5FU in eyes with poor prognoses with a similar length of follow-up. Though the numbers are small ther e is a trend that indicates that the intraoperative application of a s ingle dose of 5 FU alone may not be sufficient in eyes with moderate- to high-risk characteristics of failure of a trabeculectomy.