Successful corneal endothelium preservation in the management of epithelial downgrowth with 5-fluorouracil injections and membranectomy

BMC Ophthalmol. 2024 Oct 15;24(1):450. doi: 10.1186/s12886-024-03719-9.

Abstract

A 74-year-old Chinese man underwent extracapsular cataract extraction in his right eye and developed a translucent iris membrane 4 months later. He was treated with two intracameral 5-FU injections and membranectomy at 2 weeks apart. At one year following the second membranectomy, the patient maintained a clear cornea without residual or recurrent membrane, an endothelial cell density of 1072 cell/mm2, a visual acuity of 20/50 and a normal intraocular pressure. Our technique of using dispersive and cohesive viscoelastics in protecting the corneal endothelium from intracameral 5-FU, helped preserve corneal endothelial cells and maintain corneal clarity at one year after surgery.

Keywords: 5-Fluorouracil; Cataract surgery; Epithelial downgrowth; Methotrexate; Mitomycin-C.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antimetabolites / administration & dosage
  • Antimetabolites / therapeutic use
  • Cataract Extraction* / methods
  • Corneal Diseases / surgery
  • Endothelium, Corneal* / drug effects
  • Endothelium, Corneal* / pathology
  • Epithelium, Corneal / drug effects
  • Fluorouracil* / administration & dosage
  • Fluorouracil* / therapeutic use
  • Humans
  • Injections, Intraocular
  • Male
  • Visual Acuity

Substances

  • Fluorouracil
  • Antimetabolites