Long-term follow-up of trabeculectomy with intraoperative 5-fluorouracil for uveitis-related glaucoma.

Abstract

To determine the effect of intraoperative application of 5-fluorouracil (5-FU) on the long-term outcome of trabeculectomy in uveitis-related glaucoma. An open, prospective, noncomparative case study to evaluate the use of intraoperative application for 5 minutes of 25 mg/ml 5-FU in primary trabeculectomy for uveitis-related glaucoma. Fifty eyes of 43 consecutive patients were enrolled in the study. Data were recorded prospectively on specifically designed forms at visits every 3 months after surgery. The intraocular pressure, need for additional medication, and the need for repeat surgery were the criteria that determined the outcome of surgery. No significant intraoperative, postoperative, or late complications of 5-FU administration were noted. Successful filtration was achieved in 82% of eyes at 1 and 2 years after surgery. The success rate was 67% at 5 years. Failure was significantly more common and occurred earlier in patients of black ethnic origin. No deleterious effect on control of uveitis in relation to surgical intervention was observed. Intraoperative application of 5-FU appears to be a long-term, safe, and effective adjunct to trabeculectomy in uveitis-related glaucoma.