5-Fluorouracil for trabeculectomy in glaucoma

Abstract

The effect of 5-fluorouracil (5-FU) subconjunctival injection on the bleb formation and intraocular pressure (IOP) following trabeculectomy was studied in 18 glaucoma patients (20 eyes) with poor surgical prognosis. The results were analyzed by means of life tables and compared with those of 24 glaucoma eyes that had undergone trabeculectomy without postoperative administration of 5-FU after a previous repeat trabeculectomy that had failed. The surgical techniques and postoperative care were virtually identical between the eyes treated with 5-FU and eyes that had undergone repeat trabeculectomy, except that the latter group did not receive 5-FU postoperatively. At the end of 18-month follow-up, the success probability was 68.2% in the 5-FU treated eyes, and it was already as low as 10% in the nontreated eyes at the end of the 14-month follow-up. The difference was statistically highly significant (P less than 0.001). Postoperative, subconjunctival injection of 5-FU appears to improve the prognosis following trabeculectomy in patients with a poor surgical prognosis.

Trabeculectomy with mitomycin C: an electron microscopic and clinical study

“…The most popular agents used for fibrosis inhibition in filtering surgery have been 5-fluorouracil and mitomycin C. 5-fluorouracil is administered by subconjunctival injection which has many disadvantages including frequent injections, discomfort, corneal epithelial defects and conjunctival wound leaks [1][2][3][4][5]. On the other hand, a single intraoperative application of mitomycin at the filtering site in eyes with poor surgical candidates increases the success rate of the trabeculectomy operation [6][7][8].…”

The Glaucoma Book: What Do We Know Now, What Do We Need to Know About Glaucoma?

“…65). The most important modification of trabeculectomy was the introduction of antifibrotic agents (e.g., mitomycin-C 54 and 5-flourouracil [55][56][57][58][59][60][61][62] ) that permitted a degree of modulation of the wound healing process. Tube shunts, both unvalved and valved, continue to be introduced (Chaps.…”

Effects of bevacizumab loaded PEG-PCL-PEG hydrogel intracameral application on intraocular pressure after glaucoma filtration surgery

“…However, in order to maintain effective concentration and prolong drug retention, the operation site may need repeated conjunctival injections. Additionally, because of their nonspecific mechanisms of action, 5-FU and MMC can cause widespread cell death and apoptosis, resulting in potentially sightthreatening complications such as severe postoperative hypotony, bleb leaks, and endophthalmitis [3][4][5]. These side effects have prompted the increasing interest in the use of angiogenesis-inhibiting compounds, especially those that act against vascular endothelial growth factor (VEGF), termed anti-VEGF compounds, which are targeted at modulating the effects of VEGF on both the proliferation and migration of human fibroblasts in Tenon's capsule has arisen [6].…”