H M Towler1, P McCluskey, B Shaer, S Lightman. 1. Department of Clinical Ophthalmology, Institute of Ophthalmology, Moorfields Eye Hospital, London, England UK.
Abstract
PURPOSE: To determine the effect of intraoperative application of 5-fluorouracil (5-FU) on the long-term outcome of trabeculectomy in uveitis-related glaucoma. DESIGN: An open, prospective, noncomparative case study to evaluate the use of intraoperative application for 5 minutes of 25 mg/ml 5-FU in primary trabeculectomy for uveitis-related glaucoma. PARTICIPANTS: Fifty eyes of 43 consecutive patients were enrolled in the study. METHODS: Data were recorded prospectively on specifically designed forms at visits every 3 months after surgery. MAIN OUTCOME MEASURES: The intraocular pressure, need for additional medication, and the need for repeat surgery were the criteria that determined the outcome of surgery. RESULTS: No significant intraoperative, postoperative, or late complications of 5-FU administration were noted. Successful filtration was achieved in 82% of eyes at 1 and 2 years after surgery. The success rate was 67% at 5 years. Failure was significantly more common and occurred earlier in patients of black ethnic origin. No deleterious effect on control of uveitis in relation to surgical intervention was observed. CONCLUSIONS: Intraoperative application of 5-FU appears to be a long-term, safe, and effective adjunct to trabeculectomy in uveitis-related glaucoma.
PURPOSE: To determine the effect of intraoperative application of 5-fluorouracil (5-FU) on the long-term outcome of trabeculectomy in uveitis-related glaucoma. DESIGN: An open, prospective, noncomparative case study to evaluate the use of intraoperative application for 5 minutes of 25 mg/ml 5-FU in primary trabeculectomy for uveitis-related glaucoma. PARTICIPANTS: Fifty eyes of 43 consecutive patients were enrolled in the study. METHODS: Data were recorded prospectively on specifically designed forms at visits every 3 months after surgery. MAIN OUTCOME MEASURES: The intraocular pressure, need for additional medication, and the need for repeat surgery were the criteria that determined the outcome of surgery. RESULTS: No significant intraoperative, postoperative, or late complications of 5-FU administration were noted. Successful filtration was achieved in 82% of eyes at 1 and 2 years after surgery. The success rate was 67% at 5 years. Failure was significantly more common and occurred earlier in patients of black ethnic origin. No deleterious effect on control of uveitis in relation to surgical intervention was observed. CONCLUSIONS: Intraoperative application of 5-FU appears to be a long-term, safe, and effective adjunct to trabeculectomy in uveitis-related glaucoma.
Authors: Saleh A Al Obeidan; Essam A Osman; Abdulrahman M Al-Muammar; Ahmed M Abu El-Asrar Journal: Int Ophthalmol Date: 2008-06-19 Impact factor: 2.031