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Postoperative 5‐fluorouracil versus intraoperative mitomycin C in high‐risk glaucoma filtering surgery: extended follow up
Author(s) -
Akarsu Cengiz,
Önol Merih,
Hasanreisoglu Berati
Publication year - 2003
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1046/j.1442-9071.2003.00645.x
Subject(s) - medicine , trabeculectomy , intraocular pressure , mitomycin c , glaucoma , visual acuity , surgery , fluorouracil , randomized controlled trial , glaucoma surgery , anesthesia , retrospective cohort study , ophthalmology , chemotherapy
Purpose: To compare the long‐term efficacy and safety of postoperative subconjunctival 5‐fluorouracil (5‐FU) injections with that of intraoperative mitomycin C (MMC) in eyes at high risk for failure of trabeculectomy. Methods: In a retrospective, non‐randomized comparative trial, 36 eyes of 36 consecutive patients at high risk for failure of trabeculectomy underwent glaucoma filtering surgery with either postoperative subconjunctival 5‐FU injections (19 eyes) or intraoperative application of MMC (17 eyes). Intraocular pressure, number of postoperative antiglaucoma medications, postoperative visual acuity, interventions, and complications were evaluated. Results: Overall success (intraocular pressure ≤21 mmHg) at 1 year was 73.6% in the 5‐FU group and 82.3% in the MMC group. The cumulative 4‐year success was 52.6% in the 5‐FU group and 60.5% in the MMC group ( P = 0.6). At 4‐year follow up, mean ± SD intraocular pressures were 17.58 ± 4.01 mmHg in the 5‐FU group and 13.33 ± 3.36 mmHg in the MMC group ( P = 0.01). There was no significant difference in the number of postoperative medications ( P = 0.84), appearance of blebs ( P = 0.20), final visual acuity ( P = 1.00), and complications ( P > 0.05) between the groups. Conclusions: These results suggest that both postoperative 5‐FU injections and intraoperative MMC application have long‐term success in high‐risk patients. However, MMC results in a greater decrease in intraocular pressure than 5‐FU.