Study: Trabeculectomy with 5-FU shows continual loss of IOP control over time

SAN FRANCISCO — Patients who underwent trabeculectomy with adjunctive 5-fluorouracil injections show a continual loss of intraocular pressure control over time, despite successful IOP control after 1 year, a long-term study found.

Researchers here with the Glaucoma Research and Education Group retrospectively identified 87 eyes of 87 patients who had undergone trabeculectomy with 5-fluorouracil injections that were deemed successful at 1-year follow up. Average follow-up time was 8.1 years for these patients. All the patients had previously failed glaucoma surgery (66.7%), cataract surgery (47.1%) or other diagnoses making them a high risk for failure. Successful IOP control was defined as IOP of less than 21 mm Hg or a reduction of 33% if preop pressure was less than 21 mm Hg.

“It should be emphasized that our study involves patients successful at 1 year after surgery and does not include those failing within the first year,” the study authors report in the October issue of Ophthalmology.

The researchers found a “significant loss of IOP control” over the long term, with success rates dropping to 61% at 5 years, 44% at 10 years and 41% at 14 years. The authors suggest continual, regular follow-up in these types of patients, regardless of initial surgical success.

“However, we found that in 22 patients who achieved 10 years of successful IOP control, 21 of the 22 maintained successful control throughout the follow-up period,” they wrote.

The group plans to continue follow-up through 15 and 20 years.