Postoperative complications and short-term outcome after 5-Fluorouracil or mitomycin-C trabeculectomy

TLDR: Complications including hypotony, loss of visual acuity, choroidal effusion, shallow anterior chamber, cataract progression, hyphema and procedure failure were equivalent between 5-fluorouracil and mitomycin-C-treated groups.

Abstract: PURPOSE This study was performed to compare the postoperative complications between trabeculectomy with 5-fluorouracil injected after surgery and trabeculectomy with mitomycin-C applied intraoperatively. METHODS Retrospective review was done on 77 eyes that had received 5-fluorouracil injections after trabeculectomy, 45 eyes that received mitomycin-C during trabeculectomy, 4 eyes that received both agents, and 15 eyes that received neither agent between January 1991 and July 1992. 5-fluorouracil-treated eyes received a mean of 5 +/- 2.5 subconjunctival injections of 5 mg each (5 mg/0.1 ml). Mitomycin-C-treated eyes received 3-5 min exposure to 0.5 mg/ml mitomycin-C. Several parameters were compared between groups including hypotony defined as intraocular pressure <6 mm Hg. Success was defined as IOP <21 mm Hg with or without medications. Followup averaged 6-12 months. RESULTS Complications including hypotony, loss of visual acuity, choroidal effusion, shallow anterior chamber, cataract progression, hyphema and procedure failure were equivalent between 5-fluorouracil and mitomycin-C-treated groups. CONCLUSIONS Excluding corneal epithelial toxicity that was more common with 5-fluorouracil, the two agents used had similar success and complications during the short followup period.