Surgeon: Using 5-FU in trabeculectomy helps IOP to remain lower

SINGAPORE — Using 5-fluorouracil during trabeculectomy helped IOPs to remain significantly lower than when surgeons did not use the intraocular injection, said Steve Seah, MD. He presented results from a large long-term study in Asia here during the Asia-Pacific Academy of Ophthalmology meeting.

“This is the largest long-term glaucoma surgery trial in Asia,” Dr. Seah told attendees.

Dr. Seah said a similar study is being conducted at London’s Moorfields Eye Hospital.

A total of 235 patients were assigned to either 5-FU (115 patients) or placebo (120 patients) during trabeculectomy. The mean follow-up was 54 months, with patients completing at least 12 months of follow-up, Dr. Seah said. The primary outcomes were postoperative IOP, progressive loss of visual fields and loss in optic disc neuroretinal rim area.

Dr. Seah said success was defined as an IOP of less than 14 mm Hg, 17 mm Hg or 21 mm Hg on two separate occasions postop. Of the patients in the 5-FU group, 83 had an IOP greater than 14 mm Hg, compared with 101 of the 120 patients in the placebo group. There were 57 patients in the 5-FU group who had an IOP of more than 17 mm Hg, compared with 73 in the placebo group, Dr. Seah said.

There were no significant differences in adverse events between the two groups, Dr. Seah said. He did add there was a slight difference in the number of patients who developed uveitis, but he said it was not statistically significant.