Comparison of phacotrabeculectomy with 5-fluorouracil, mitomycin-C, and without antifibrotic agents

Ophthalmic Surg Lasers. 1999 May;30(5):367-74.

Abstract

Background and objective: To evaluate the potential benefits, complications, and prognostic risk factors for failure of phacotrabeculectomy performed with or without 5-fluorouracil (5-FU) and mitomycin-C (MMC).

Patients and methods: Retrospective chart review of 78 patients who underwent phacotrabeculectomy during a 2-year period. Patients were divided into 3 groups, those who received 5-FU (N = 28). MMC (N = 29), or no antifibrotic agent (N = 21).

Results: All 3 groups had statistically significant lower intraocular pressures (IOP) on fewer antiglaucomatous medications at 6-month, 12-month, and last follow-up compared to preoperative levels (P < .05). Intraocular pressures were lower in the group that received MMC compared to the 5-FU group, but not in the group that did not receive antimetabolites, at all time intervals measured (P < .05). Black race was a strong predictor of failure of trabeculectomy (P = 009). No differences in final visual acuity or complications were found between groups.

Conclusions: Phacotrabeculectomy is effective regardless of antimetabolite use. Race is a strong predictor of failure.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Cataract / complications
  • Chemotherapy, Adjuvant
  • Fibrosis / drug therapy
  • Fluorouracil / administration & dosage
  • Fluorouracil / therapeutic use*
  • Glaucoma / complications
  • Glaucoma / surgery
  • Humans
  • Intraocular Pressure
  • Intraoperative Period
  • Lens Implantation, Intraocular*
  • Mitomycin / administration & dosage
  • Mitomycin / therapeutic use*
  • Ophthalmic Solutions
  • Phacoemulsification*
  • Retrospective Studies
  • Trabeculectomy*
  • Treatment Outcome
  • Visual Acuity

Substances

  • Ophthalmic Solutions
  • Mitomycin
  • Fluorouracil