5-Fluorouracil for trabeculectomy in glaucoma.

The effect of 5-fluorouracil (5-FU) subconjunctival injection on the bleb formation and intraocular pressure (IOP) following trabeculectomy was studied in 18 glaucoma patients (20 eyes) with poor surgical prognosis. The results were analyzed by means of life tables and compared with those of 24 glaucoma eyes that had undergone trabeculectomy without postoperative administration of 5-FU after a previous repeat trabeculectomy that had failed. The surgical techniques and postoperative care were virtually identical between the eyes treated with 5-FU and eyes that had undergone repeat trabeculectomy, except that the latter group did not receive 5-FU postoperatively. At the end of 18-month follow-up, the success probability was 68.2% in the 5-FU treated eyes, and it was already as low as 10% in the nontreated eyes at the end of the 14-month follow-up. The difference was statistically highly significant (P less than 0.001). Postoperative, subconjunctival injection of 5-FU appears to improve the prognosis following trabeculectomy in patients with a poor surgical prognosis.