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Antimetabolites with filter show long-term success; mitomycin more effective at 4 years
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Filtering surgery with adjunctive antimetabolites had long-term success in high-risk patients, according to a recently published study. Postoperative administration of mitomycin C helped lower intraocular pressure more than intraoperative 5-fluorouracil in patients with 4-year follow-up, the study authors said.
Cengiz Akarsu, MD, and colleagues in Turkey conducted a retrospective, nonrandomized trial to compare the long-term efficacy and safety of postoperative subconjunctival 5-FU with intraoperative mitomycin C (MMC) in patients with a high risk of failed trabeculectomy.
Nineteen eyes underwent glaucoma filtering surgery with 5-FU injections and 17 eyes underwent glaucoma filtering surgery with intraocular application of MMC. IOP, number of postoperative medications, postop visual acuity, interventions and complications were all evaluated.
At year 1, 73.6% of patients in the 5-FU group and 82.3% of patients in the MMC group had an IOP of less than 21 mm Hg. Cumulatively, the 4-year success rate for patients in the 5-FU group was 52.6% and for the MMC group 60.5%.
At 4 years, the mean IOP decreased to 17.58 mm Hg in the 5-FU group and to 13.33 mm Hg in the MMC group.
No significant differences in the number of postop medications, appearance of blebs, final visual acuity or complications were noted between the groups.
The study is published in the June issue of Clinical & Experimental Ophthalmology.