Abdul Majeed, Mushtaq Ahmed Baig, M Daud Khan.
Intraoperative 5-Fluorouracil as an adjunct Chemotherapy with Trabeculectomy.
Pak J Ophthalmol Jan ;15(2):72-8.

Previous data and laboratory studies using various antimetabolites as adjuncts to glaucoma filtration surgery suggest that single application of 5-fluorouracil (5-FU) during trabeculectomy has as much effect as multiple postoperative subconjunctival injections of 5-FU on the proliferation of subconjunctival fibroblasts. However, this effect is much less prolonged as compared with mitomycin C (MMC). We carried out a prospective study on 17 Pakistani patients. Twenty-seven eyes of glaucoma patients with a relatively higher risk of filtration surgery failure were operated on, using 5-FU (25 mg/ml) as a single application between the conjunctival flap and the sclera. Patients were followed-up for 3-12 months. No failures were seen in low/moderate risk eyes, while 3 high risk eyes failed completely and one required topical B-blocker to control the intraocular pressure. Our small study showed that single intraoperative exposure to 5-FU for 5 mins. Is convenient inexpensive, relatively free of toxic effects and has lesser postoperative complications as compared to 5-FU injections or MMC. Therefore, it can be considered as a useful adjunct to trabeculectomy, particularly in patients at higher risk of filtration surgery failure.

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