Intraoperative 5-FU considered valuable agent in patients undergoing trabeculectomy

May 3

- Fort Lauderdale, FL - A single exposure of 5-fluorouracil (5-FU) lasting 5 minutes during trabeculectomy may improve the long-term IOP-lowering effect of the surgery without causing any serious adverse events, according to Steve Seah, MD, who reported the results of the Singapore 5-FU Study at the Association for Research in Vision and Ophthalmology annual meeting.

In a prospective, randomized and masked study, 243 patients with primary glaucoma underwent trabeculectomy and received a sponge application of 5-FU (50 mg/ml) or placebo. Patients were followed for an average of 54 months.

Outcomes were based on postoperative IOP at three different threshold levels (14, 17, and 21 mm Hg). Patients were also assessed for visual field loss and optic disc damage. Additional treatments required and adverse events were reported.

Patients who received a 5-FU application (n=120) fared better in terms of postoperative IOP at the 14 and 17 mm Hg threshold levels than those treated with placebo (n=123). There was a lower failure rate for these patients compared to placebo, said Dr. Seah of the Singapore National Eye Center, Singapore.

"There was no significant difference between the two groups in terms of IOP greater than 21 mm Hg," he continued.

In addition, the researchers found that there was no significant difference in the need for additional treatments after trabeculectomy in the two groups, no significant difference in visual field loss or optic disc damage, and no difference in serious adverse events, such as blebitis, endophthalmitis, hypotony, and cataract, Dr. Seah said.