Trabeculectomy with intraoperative sponge 5-fluorouracil in Afro-Caribbeans

Abstract

Aim: To study the efficacy and safety of intraoperative 5-fluorouracil (5-FU) in Afro-Caribbean patients.

Methods: The results of trabeculectomy in 18 eyes of 18 Afro-Caribbean patients in whom a sponge soaked in 25 mg/ml solution of 5-FU was applied between Tenon's capsule and sclera for 5 minutes before excision of the trabecula were compared with 16 eyes of 16 Afro-Caribbean patients matched for age, quantity, and duration of preoperative medications, who underwent trabeculectomy without 5-FU.

Results: The mean postoperative intraocular pressure (IOP) at 1 month was 15.6 (SD 6.1) mm Hg in the 5-FU group and 18.0 (5.2) mm Hg in the control group (p = 0.15). There was no significant difference in the IOP at 6, 12, 15, 18, and 24 months in the two groups. Success rate at 18 months defined as an IOP less than or equal to 21 mm Hg with no adjunctive medication was 56% in the 5-FU group and 55% in the control group. No major complications were noted in either group.

Conclusion: Intraoperative sponge 5-FU alone is safe but does not appear to decrease the risk of failure of trabeculectomy in Afro-Caribbeans.

Figure 1

Evolution of intraocular pressure in the 5-FU group.

Figure 2

Evolution of intraocular pressure in the control group.

Figure 3

Comparison of the intraocular pressure evolution between the 5-FU and the control group.

Figure 4

Kaplan-Meier analysis of the probability of IOP survival < 22 mm Hg.