Trabeculectomy with intraoperative sponge 5-fluorouracil

Abstract

Purpose: To retrospectively assess the outcome of trabeculectomy surgery performed using intraoperative sponge 5-fluorouracil (5-FU) (50 mg/ml).

Methods: Trabeculectomy with intraoperative sponge 5-FU was performed on 140 eyes of 119 patients. The reduction in intraocular pressure (IOP), the number of supplementary postoperative injections, and any treatment complications were noted.

Results: The mean preoperative IOP was 25.7 +/- 8.6 mmHg. The mean postoperative IOP was 12.5 +/- 5.7 mmHg with a mean IOP reduction of 52 percent (P < 0.0001). One hundred twenty-one (86.4 percent) eyes required no postoperative glaucoma medications, with the mean number of glaucoma medications dropping from 2.5 +/- 1.1 before operation to 0.3 +/- 0.8 after operation (P < 0.001). One hundred five eyes received a mean of 5.3 +/- 2.7 postoperative 5-FU injections. There was no significant difference in final IOP or success rate between low- and high-risk eyes, but high-risk eyes seemed to require supplementary postoperative 5-FU. Corneal epithelial damage arose in 52 (37 percent) eyes and correlated strongly with postoperative 5-FU supplementation.

Conclusion: Intraoperative sponge 5-FU is a reasonably safe and effective adjunct to trabeculectomy surgery.