Postoperative 5-fluorouracil versus intraoperative mitomycin C in high-risk glaucoma filtering surgery: extended follow up

Authors: Akarsu C.¹; Önol M.²; Hasanreisoglu B.²

Source: Clinical & Experimental Ophthalmology, Volume 31, Number 3, June 2003 , pp. 199-205(7)

Publisher: Wiley-Blackwell

Abstract:

Purpose: To compare the long-term efficacy and safety of postoperative subconjunctival 5-fluorouracil (5-FU) injections with that of intraoperative mitomycin C (MMC) in eyes at high risk for failure of trabeculectomy.

Methods: In a retrospective, non-randomized comparative trial, 36 eyes of 36 consecutive patients at high risk for failure of trabeculectomy underwent glaucoma filtering surgery with either postoperative subconjunctival 5-FU injections (19 eyes) or intraoperative application of MMC (17 eyes). Intraocular pressure, number of postoperative antiglaucoma medications, postoperative visual acuity, interventions, and complications were evaluated.

Results: Overall success (intraocular pressure 21 mmHg) at 1 year was 73.6% in the 5-FU group and 82.3% in the MMC group. The cumulative 4-year success was 52.6% in the 5-FU group and 60.5% in the MMC group (P = 0.6). At 4-year follow up, mean ± SD intraocular pressures were 17.58 ± 4.01 mmHg in the 5-FU group and 13.33 ± 3.36 mmHg in the MMC group (P = 0.01). There was no significant difference in the number of post­operative medications (P = 0.84), appearance of blebs (P = 0.20), final visual acuity (P = 1.00), and complications (P > 0.05) between the groups.

Conclusions: These results suggest that both postoperative 5-FU injections and intraoperative MMC application have long-term success in high-risk patients. However, MMC results in a greater decrease in intraocular pressure than 5-FU.

Keywords: 5-fluorouracil; glaucoma; mitomycin C; trabeculectomy; high-risk surgery

Document Type: Research article

DOI: http://dx.doi.org/10.1046/j.1442-9071.2003.00645.x

Affiliations: 1: Department of Ophthalmology, School of Medicine, University of Krkkale, Krkkale, and rkkale, Krkkale, and "> 2: Department of Ophthalmology, School of Medicine, Gazi University, Ankara, Turkey

Publication date: 2003-06-01

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