| Efficacy and Safety of Subconjunctivally Injected 5-fluorouracil after Mitomycin C Trabeculectomy in High Risk Patients. |
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Michael S Kook, Chul Sin Moon |
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Department of Ophthalmology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea. |
| Mitomycin C 섬유주절제술을 시행한 고위험녹내장 환자에서 5-fluorouracil 결막하 주사의 효과 |
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국문석(Michael S . Kook),문철신(Chul Sin Moon) |
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| Abstract |
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To determine the safety and efficacy of using subconjunctival 5- fluorouracil(5-FU) injection on high risk eyes for filtration failure who had undergone trabeculectomy with intraoperative mitomycin C(MMC), we conducted a retrospective analysis of 17 eyes of 17 consecutive patients. Intraoperative MMC exposure (0.4mg/ml) was followed by supplemental postoperative 5-FU injection as necessary to titrate bleb vascularity and intraocular pressure (IOP). Exposure time to MMC was 2 to 5 minutes based on multiple preoperative and intraoperative risk factors. Postoperative 5-FU was administered by subconjunctival injection(5mg) adjacent to or into the bleb in a weekly interval(mean 4 injections, range 2-5 injections). Mean follow-up time was 8.6 months. Overall mean preoperative IOP was 27.1+/-7.2mmHg compared with mean postoperative IOP of 12.3+/-7.4mmHg. Fifteen eyes(88%) achieved a final IOP < OR =21mmHg without medicatio and 11 eyes(64%) achieved a final IOP< OR =12mmHg. Complications developed after 5-FU injections included corneal epithelial defect in 2 eyes (12%), hypotony (IOP< OR =5, at least 2 visits) in 2 eyes(12%), and bleb leakage in 1 eye(6%). No patient had a hypotony induced maculopathy, hyphema or choroidal effusion. Our data suggest that postoperative 5-FU may be safely used adjunctively following MMC trabeculectomy in carefully selected patients, and may improve the overall success rate with high risk trabeculectomy. |
| Key Words:
trabeculectomy;mitomycin C;5-fluorouracil;bleb failure |
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