[Antimetabolites in glaucoma surgery--long-term results].

PURPOSE

To observe the long term success of antimetabolites used in glaucoma filtering surgery in eyes with high risc of failure.

MATERIAL AND METHOD

Two groups of patients undergone trabeculectomy with the use of antimetabolites 5-Fluorouracil (5-FU) and Mitomycin C (MMC) are included in this retrospective study. 5-FU was administered postoperatively 1-10 times in the dose of 5 mg/ml in subconjunctival injection on 32 eyes. Follow up time ranged from 8 months to 9 years. Mitomycin C was administered intraoperatively in the dose of 0.2 mg/ml, on subconjunctival sponge with application time from 3 to 5 minutes on 15 eyes. Follow up time ranged from 7 month to 4.5 years.

RESULTS

Intraocular pressure (IOP) before operation with the use of 5-FU was in average 28.8 mmHg (22-50 mmHg) at the end of therapy with 5-FU was 17.6 mmHg (10-30 mmHg) and in the last examination was on average 19.5 mmHg (14-28 mmHg). IOP before operation with the use of MMC was in average 30.3 mmHg (22-40 mmHg), the seventh day after administration of MMC 12.7 mmHg (6-20 mmHg) and in the last examination was in average 18 mmHg (9-28 mmHg). During the long term observation of IOP values in the 5-FU group there was 79.2% success and in the MMC group there was 83.3% success (IOP up to 20 mmHg with or without therapy). Decrease of IOP was statistically significant.

CONCLUSION

Antimetabolites improve the success of filtering surgery in high risc glaucomas. The long term follow up shows that failure of filtration in these types of glaucomas is still a serious clinical problem.