Significant systemic absorption of 5-FU possible

Surgeons should avoid using 5-fluorouracil in children and young adults because its use may lead to “significant general absorption,” according to a small case series.

Peter Stalmans, MD, PhD, and colleagues at the University Hospital Leuven in Belgium described two cases where the patient underwent vitrectomy with 5-FU as the infusion fluid and systemic absorption was present. While 5-FU has been shown to reduce the rate of proliferative vitreoretinopathy (PVR), no positive effect on the success rate of surgery for established PVR has been proven, according to the study.

The two patients underwent a three-port pars plana vitrectomy using intravitreal infusion with 5-FU and low molecular weight heparin. The first patient was infused for 20 minutes, with a total of 250 mL of infusion fluid. The second patient had a 40-minute intervention and a total of 350 mL of infusion.

A catabolite of the 5-FU was measured in the urine samples of both patients up to 48 hours after surgery, according to the study. “Therefore, although the total administered dose is extremely small compared with the dosages used in chemotherapy, 5-FU is systemically absorbed and systemic side effect cannot be excluded,” the authors said.

The report is published in the July issue of American Journal of Ophthalmology.