Efficacy and Safety of Subconjunctivally Injected 5-fluorouracil after Mitomycin C Trabeculectomy in High Risk Patients.
- Author:
Michael S KOOK
1
;
Chul Sin MOON
Author Information
1. Department of Ophthalmology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
trabeculectomy;
mitomycin C;
5-fluorouracil;
bleb failure
- MeSH:
Blister;
Choroid;
Filtration;
Fluorouracil*;
Follow-Up Studies;
Humans;
Hyphema;
Intraocular Pressure;
Mitomycin*;
Retrospective Studies;
Risk Factors;
Trabeculectomy*
- From:Journal of the Korean Ophthalmological Society
1997;38(7):1236-1243
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
To determine the safety and efficacy of using subconjunctival 5- fluorouracil(5-FU) injection on high risk eyes for filtration failure who had undergone trabeculectomy with intraoperative mitomycin C(MMC), we conducted a retrospective analysis of 17 eyes of 17 consecutive patients. Intraoperative MMC exposure (0.4mg/ml) was followed by supplemental postoperative 5-FU injection as necessary to titrate bleb vascularity and intraocular pressure (IOP). Exposure time to MMC was 2 to 5 minutes based on multiple preoperative and intraoperative risk factors. Postoperative 5-FU was administered by subconjunctival injection(5mg) adjacent to or into the bleb in a weekly interval(mean 4 injections, range 2-5 injections). Mean follow-up time was 8.6 months. Overall mean preoperative IOP was 27.1+/-7.2mmHg compared with mean postoperative IOP of 12.3+/-7.4mmHg. Fifteen eyes(88%) achieved a final IOP < OR =21mmHg without medicatio and 11 eyes(64%) achieved a final IOP< OR =12mmHg. Complications developed after 5-FU injections included corneal epithelial defect in 2 eyes (12%), hypotony (IOP< OR =5, at least 2 visits) in 2 eyes(12%), and bleb leakage in 1 eye(6%). No patient had a hypotony induced maculopathy, hyphema or choroidal effusion. Our data suggest that postoperative 5-FU may be safely used adjunctively following MMC trabeculectomy in carefully selected patients, and may improve the overall success rate with high risk trabeculectomy.
