Wong P C, Ruderman J M, Krupin T, Goldenfeld M, Rosenberg L F, Shields M B, Ritch R, Liebmann J M, Gieser D K
Department of Ophthalmology, Northwestern University, Chicago, Illinois.
Am J Ophthalmol. 1994 Feb 15;117(2):149-54. doi: 10.1016/s0002-9394(14)73069-7.
We examined the safety and efficacy of 5-fluorouracil in eyes with open-angle glaucoma undergoing combined cataract removal and filtration surgery. We randomly assigned one eye each of 24 patients to receive 5-fluorouracil (five injections of 5 mg during two weeks after surgery) and one eye each of 20 patients to comprise the control group. Preoperatively, the two groups had similar mean intraocular pressure (P = .8) and number of medications (P = .2). The mean intraocular pressure of the 5-fluorouracil group was 18.6 +/- 1.1 mm Hg, with 2.5 +/- 0.3 medications; that of the control group was 18.2 +/- 1.2 mm Hg, with 2.2 +/- 0.2 medications. One year postoperatively, intraocular pressure and the number of medications were significantly reduced by a similar amount in both groups of patients (5-fluorouracil, 14.2 +/- 0.7 mm Hg, 0.8 +/- 0.2 medications; controls, 14.3 +/- 0.6 mm Hg, 1.0 +/- 0.2 medications). Transient superficial punctate keratopathy occurred more frequently (P = .04) in the 5-fluorouracil group (16 of 24 eyes, 67%) than in the control group (seven of 20 eyes, 35%). In our randomized and prospective study, the adjunctive use of 5-fluorouracil did not result in improved control of intraocular pressure one year after combined surgery in eyes with open-angle glaucoma.
我们研究了5-氟尿嘧啶在接受白内障摘除联合滤过手术的开角型青光眼患者眼中的安全性和有效性。我们将24例患者的每只眼睛随机分配，其中一只眼睛接受5-氟尿嘧啶治疗（术后两周内注射5次，每次5毫克），另外20例患者的每只眼睛作为对照组。术前，两组的平均眼压相似（P = 0.8），用药数量也相似（P = 0.2）。5-氟尿嘧啶组的平均眼压为18.6±1.1毫米汞柱，用药2.5±0.3种；对照组的平均眼压为18.2±1.2毫米汞柱，用药2.2±0.2种。术后一年，两组患者的眼压和用药数量均显著降低，且降低幅度相似（5-氟尿嘧啶组，14.2±0.7毫米汞柱，用药0.8±0.2种；对照组，14.3±0.6毫米汞柱，用药1.0±0.2种）。5-氟尿嘧啶组发生短暂性浅层点状角膜病变的频率更高（P = 0.04）（24只眼中有16只，占67%），高于对照组（20只眼中有7只，占35%）。在我们的随机前瞻性研究中，对于开角型青光眼患者，联合手术一年后，辅助使用5-氟尿嘧啶并未改善眼压控制情况。
