Use of 5-Fluorouracil injections to reduce the risk of trabeculectomy bleb failure after cataract surgery

• Published in: Journal of ocular pharmacology and therapeutics Vol. 26; no. 1; p. 119
• Main Authors: Shahid, Humma, Salmon, John F
• Format: Journal Article
• Language: English
• Published: United States 01.02.2010
• Subjects: Aged; Aged, 80 and over; Cataract - complications; Cataract Extraction - adverse effects; Cataract Extraction - methods; Conjunctiva; Drug Administration Schedule; Female; Fluorouracil - administration & dosage; Follow-Up Studies; Glaucoma, Open-Angle - complications; Glaucoma, Open-Angle - surgery; Humans; Injections, Intraocular; Male; Middle Aged; Phacoemulsification; Postoperative Care; Postoperative Complications - prevention & control; Trabeculectomy - adverse effects; Treatment Failure
• ISSN: 1557-7732
• DOI: 10.1089/jop.2009.0067

To determine whether the use of postoperative subconjunctival 5-fluorouracil (5-FU) reduces the risk of trabeculectomy bleb failure after uncomplicated small incisional cataract surgery. Twenty-five consecutive patients with primary open-angle glaucoma and a functioning trabeculectomy bleb and who underwent uncomplicated phacoemulsification surgery were given subconjunctival injections of 5 mg 5-FU at 2, 4, and 12 weeks after cataract surgery (5-FU group). The mean postoperative intraocular pressure (IOP) over a 2-year period and the trabeculectomy survival rate, as determined by Kaplan-Meier survival analysis, was compared with a historical series of patients who had undergone cataract surgery in the presence of a filtering trabeculectomy bleb, but who had not received 5-FU (control group). After a 2-year follow-up period, there was no significant difference in the mean IOP between the 5-FU (15.1 mm Hg SD 3.1) and control (15.3 mm Hg SD 3.3) groups (P = 0.67). An IOP > 21 mm Hg at any time point after the first postoperative month after cataract surgery was found in 4.0% cases in the 5-FU group and 16.7% cases in the control group (P = 0.78). Using Kaplan-Meier survival analysis, the difference in the cumulative probability of survival between the 5-FU and control groups was not significant (P = 0.30). Cataract surgery is a significant risk factor for trabeculectomy bleb failure. The use of subconjunctival 5-FU injections at 2, 4, and 12 weeks after cataract surgery in elderly white patients with primary open-angle glaucoma does not reduce the risk of trabeculectomy failure.