Heuer D K, Parrish R K, Gressel M G, Hodapp E, Desjardins D C, Skuta G L, Palmberg P F, Nevárez J A, Rockwood E J
Ophthalmology. 1986 Dec;93(12):1537-46. doi: 10.1016/s0161-6420(86)33542-5.
Ninety-five patients (104 eyes) were enrolled in a pilot study of subconjunctival 5-fluorouracil (5-FU) injections after filtering surgery in eyes with poor surgical prognoses. At least a six-month follow-up was available on 84 patients, of whom four were excluded from the analysis of surgical outcome because they suffered retinal detachments within six months of their filtering surgery. The initial 5-FU procedures on the remaining 80 patients were successful (no further glaucoma surgical procedures were either performed or recommended, and the intraocular pressures [IOPs] were either 21 mmHg or lower with ocular hypotensive medication[s] or 25 mmHg or lower without ocular hypotensive medication) in 33 (68%) of the 48 aphakic eyes with non-neovascular glaucomas, 13 (81%) of the 16 phakic eyes with non-neovascular glaucomas after unsuccessful filtering surgery, and 12 (75%) of the 16 eyes with neovascular glaucoma (NVG). The follow-up on the successful eyes ranged from 6 to 34 months (mean +/- SD = 18.5 +/- 7.5). The visual acuities remained within one line of their preoperative levels or improved in 38 (79%) of the 48 aphakic eyes with non-neovascular glaucoma, 11 (69%) of the 16 phakic eyes with non-neovascular glaucoma after unsuccessful filtering surgery, and 12 (75%) of the 16 eyes with NVG. The initial 5-FU procedures on the 104 eyes were complicated by the following: corneal epithelial defects (50%); conjunctival wound and suture tract leaks (36%; 2% underwent surgical repair); suprachoroidal hemorrhages (9%); retinal detachments (3%); subepithelial corneal scarring (3%); endophthalmitis (2%); and malignant glaucoma (1%). It is the authors' impression that postoperative subconjunctival 5-FU increases the likelihood of achieving IOP control after filtering surgery in eyes with poor surgical prognoses; however, a randomized clinical trial is necessary to confirm this impression.
95例患者（104只眼）纳入了一项针对手术预后较差的眼睛在滤过手术后结膜下注射5-氟尿嘧啶（5-FU）的初步研究。84例患者至少有6个月的随访资料，其中4例因在滤过手术后6个月内发生视网膜脱离而被排除在手术结果分析之外。其余80例患者最初的5-FU治疗程序成功（未进行或不建议进一步进行青光眼手术，使用降眼压药物时眼压[IOP]为21 mmHg或更低，未使用降眼压药物时眼压为25 mmHg或更低），在48只无晶状体眼合并非新生血管性青光眼的患者中有33只（68%），在16只晶状体眼合并滤过手术失败后的非新生血管性青光眼患者中有13只（81%），在16只新生血管性青光眼（NVG）患者中有12只（75%）。成功眼的随访时间为6至34个月（平均±标准差=18.5±7.5）。48只无晶状体眼合并非新生血管性青光眼的患者中有38只（79%）、16只晶状体眼合并滤过手术失败后的非新生血管性青光眼患者中有11只（69%）、16只NVG患者中有12只（75%）的视力保持在术前水平的一行以内或有所提高。104只眼最初的5-FU治疗程序出现了以下并发症：角膜上皮缺损（50%）；结膜伤口和缝线道渗漏（36%；2%接受了手术修复）；脉络膜上腔出血（9%）；视网膜脱离（3%）；角膜上皮下瘢痕形成（3%）；眼内炎（2%）；恶性青光眼（1%）。作者的印象是，术后结膜下注射5-FU可增加手术预后较差的眼睛在滤过手术后实现眼压控制的可能性；然而，需要进行一项随机临床试验来证实这一印象。
