Intra-operative use of 5-fluorouracil in glaucoma filtering surgery.

This study reviews the outcome of 14 eyes considered to be at risk of surgical failure undergoing trabeculectomy with 5-Fluorouracil (5-FU). The antimetabolite was administered intra-operatively by placing a surgical sponge soaked in 5-FU (25 mg/ml) directly on the sclera under the conjunctival flap for 5 minutes. All eyes showed a reduction in intraocular pressure (IOP) at a mean follow-up of 18.5 weeks, and only one eye required topical antiglaucoma medication. Mean IOP reduction at final follow-up was 43.1%. No eyes showed any corneal problems associated with the intra-operative use of 5-FU. These results suggest that the intra-operative use of 5-Fluorouracil is an effective way of improving surgical success in at risk eyes. The early complications appear to be less than those associated with post-operative subconjunctival injections of 5-FU, but the long-term differences are still to be shown.