Subconjunctival 5-FU injections after filtration surgery spur corneal complications

Cornea. 2010;29(7):727-731.

Subconjunctival 5-fluorouracil injections after glaucoma surgery produced short-term corneal complications, a study showed.

Multiple injections of 5-FU, an antimetabolite agent, increase the success rate of filtration surgery in eyes at high risk of surgical failure, the study authors said.

"However, the improved success from using 5-FU is accompanied by an increased postoperative complication rate," they said.

The study included patients classified in three groups. The first group comprised 15 eyes of 15 patients who successfully underwent filtration surgery and received subconjunctival injections of 5-FU. The second group included 15 unoperated eyes of the same 15 patients treated with anti-glaucomatous eye drops. The third group comprised 12 healthy controls with no ocular surface disease or related symptoms.

Investigators assessed tear breakup time, fluorescein staining, Schirmer I testing and impression cytology of the bulbar conjunctiva.

Conjunctival cytology changes were graded on a three-point scale. Between-group differences in impression cytology grade were statistically insignificant because of the small sample size, the authors said.

In addition, two eyes in the first group had apoptosis and seven eyes had nuclear atypia.

Further study comparing impression cytological findings in patients undergoing filtering surgery with and without 5-FU injections is being planned. Patients treated with subconjunctival injections of 5-FU may be at an increased risk of limbal stem cell deficiency, the authors said.

Follow OSNSuperSite.com on Twitter.