Hugkulstone C E, Vernon S A
Department of Ophthalmology, University Hospital, Nottingham, United Kingdom.
Ophthalmic Surg Lasers. 1996 Nov;27(11):910-6.
5-Fluorouracil (5-FU) has been used to improve the outcome of trabeculectomy in high-risk cases, employing a postoperative regimen of subconjunctival injections. In light of recent laboratory evidence of the use of perioperative exposure to 5-FU, the authors investigated the outcome of this approach in their patients.
Twenty-three eyes of 21 patients who underwent trabeculectomy with a perioperative application of low-dose (25 mg/ml) 5-FU, with a minimum follow-up of 1 year, were reviewed retrospectively.
At 1 year postoperatively, 15 (65%) of the eyes had an intraocular pressure (IOP) of less than 21 mm Hg without treatment and 3 (13%) of the eyes achieved the same IOP with the same number of or fewer medications compared with on admission. The outright successful patients had a significantly shorter disease duration than the remaining patients (P < .05), despite having used a similar number of treatments on admission, and also had a significantly lower mean number of indications for antimetabolite use (P < .02). Few complications attributable to 5-FU were noted.
This route of administration appears to be safe and effective in patients requiring trabeculectomy who are not at a high risk for failure.
5-氟尿嘧啶（5-FU）已被用于改善高风险病例小梁切除术的效果，采用结膜下注射的术后治疗方案。鉴于近期围手术期使用5-FU的实验室证据，作者对其患者采用这种方法的效果进行了研究。
回顾性分析21例患者的23只眼，这些患者接受了小梁切除术，并在围手术期应用了低剂量（25mg/ml）5-FU，随访至少1年。
术后1年，15只眼（65%）未经治疗眼压（IOP）低于21mmHg，3只眼（13%）与入院时相比，使用相同数量或更少药物达到相同IOP。完全成功的患者疾病持续时间明显短于其余患者（P<.05），尽管入院时使用的治疗次数相似，且抗代谢药物使用的平均指征数量也明显更低（P<.02）。很少有归因于5-FU的并发症。
对于不需要高风险失败的小梁切除术患者，这种给药途径似乎是安全有效的。
