Yorston D, Khaw P T
Kikuyu Eye Unit, Kikuyu, Kenya.
Br J Ophthalmol. 2001 Sep;85(9):1028-30. doi: 10.1136/bjo.85.9.1028.
To determine if intraoperative application of 5-fluorouracil (5-FU) improves the prognosis for trabeculectomy in east Africa.
68 eyes with chronic open angle glaucoma were included in a randomised trial of intraoperative 5-FU versus placebo. Main outcome measures were intraocular pressures at 6 months and probability of failure at 2 years.
180 days after surgery the mean intraocular pressure (IOP) was 17.4 (SD 6.1) mm Hg in the placebo group and 16.9 (5.8) mm Hg in the 5-FU group. By 2 years after trabeculectomy, the probability of successful IOP control was 70.6% in the placebo group, and 88.8% in the 5-FU group. The placebo group was 2.18 times (95% CI 0.67 to 7.15) more likely to require additional IOP lowering procedures than the 5-FU group. Among patients followed for 2 years, 30% lost 0.3 logMAR units of visual acuity.
Trabeculectomy in Africa has an acceptable success rate which may be enhanced by the use of intraoperative 5-FU. It is estimated that this would cost approximately 1.25 pounds sterling per trabeculectomy failure prevented.
确定术中应用5-氟尿嘧啶（5-FU）是否能改善东非小梁切除术的预后。
68例慢性开角型青光眼患者被纳入一项术中5-FU与安慰剂对比的随机试验。主要观察指标为6个月时的眼压及2年时的失败概率。
术后180天，安慰剂组的平均眼压（IOP）为17.4（标准差6.1）mmHg，5-FU组为16.9（5.8）mmHg。小梁切除术后2年，安慰剂组眼压成功控制的概率为70.6%，5-FU组为88.8%。安慰剂组需要额外降低眼压程序的可能性是5-FU组的2.18倍（95%可信区间0.67至7.15）。在随访2年的患者中，30%的患者视力下降了0.3 logMAR单位。
非洲的小梁切除术成功率尚可，术中使用5-FU可能会提高成功率。据估计，每预防一例小梁切除术失败大约需要花费1.25英镑。
