TRABECULECTOMY SURVIVAL WITH AND WITHOUT INTRAOPERATIVE 5-FLUOROURACIL APPLICATION IN AN ASIAN POPULATION

Purpose: To define and compare the trabeculectomy survival with regard to intra-ocular pressure (IOP) control without further surgery or ant i-glaucoma medication in an Asian population. Methods: A retrospective review of two consecutive groups of patients who had trabeculectomy s urgery in a university eye department setting. The first group of pati ents (group A) did not receive any adjunctive 5-fluorouracil (5-FU), w hile the second group (group B) had intra-operative sponge application of 5-FU. Only the first trabeculectomy of patients who had bilateral trabeculectomy and the first trabeculectomy performed in patients who had repeated surgery was analysed. Combined procedures were excluded. Survival analysis was performed using the Kaplan-Meier product limit m ethod. Results: Eighty-nine patients (51 in group A and 38 in group B) were studied. with a mean follow up of 37.5 and 27.0 months. respecti vely (P = 0.014). There were no statistical differences in age, gender . mean pretreatment IOP-preoperative medication. proportion of patient s with previous ocular surgery, or proportion of primary compared with secondary glaucoma between the two groups. The probability of trabecu lectomy survival (IOP < 22 mmHg without additional medication/surgery) at 12 and 36 months was 54.3 and 36.4%, respectively, in group A and 75.8 and 65.8%, respectively, in group B. The differences in survival were significant (P = 0.006, log rank test). Conclusions: Our experien ce with trabeculectomy survival in the Asian population showed poorer success when compared with Caucasian populations reported by other inv estigators. The survival of trabeculectomy surgery was improved signif icantly with intra-operative 5-FU. There may be justification for advo cating a more liberal use of intraoperative 5-FU in such a population.