Trabeculectomy with 5-fluorouracil

The effect of subconjunctival injection of 5-fluorouracil (5-FU) after trabeculectomy was studied retrospectively in 205 eyes of 168 patients. A life table analysis of the surgical outcome was based on the type of glaucoma and age related differences, and a comparison was made with patients who had trabeculectomy without subconjunctival 5-FU. The success rate at 30 months after trabeculectomy with 5-FU therapy was considerably higher in primary open-angle glaucoma at 93.6% (72.7%), secondary glaucoma at 88.9% (72.4%), and refractory glaucoma at 72.2% (32.5%) with (or without) the use of ocular hypotensive drops when compared with historical control groups treated without 5-FU (60.0% (41.7%), 35.5% (24.0%), and 18.0% (8.0%), respectively). In patients aged over 70 years, no statistically significant improvement could be demonstrated with the use of 5-FU after trabeculectomy in primary open-angle glaucoma. Our study may provide data on the appropriate dosage and indications for the use of this drug after glaucoma surgery.