Lamba P A, Pandey P K, Raina U K, Krishna V
Maulana Azad Medical College, New Delhi.
Indian J Ophthalmol. 1996 Sep;44(3):157-60.
Thirty three eyes of 33 patients were prospectively evaluated to study the short term efficacy, and overall surgical outcome of initial trabeculectomy for primary glaucomas with adjunctive intraoperative on postoperative 5-Fluorouracil (5-FU) use. Twelve eyes served as control who underwent trabeculectomy without adjunctive antimetabolites. Eleven eyes received intraoperative 5-FU, while 10 eyes received subconjunctival 5-FU postoperatively. Intraocular pressure (IOP) was maintained below 22 mmHg at 3 months of follow up in 90.9% and 80% of patients in the intraoperative and postoperative 5-FU groups respectively, without use of additional antiglaucoma medications, whereas 66.7% of the patients in the control group achieved similar IOP levels. Hypotony (I.O.P. < 6 mmHg) was seen more commonly after intraoperative 5-FU (27.3%). Corneal epithelial defects were seen exclusively in the postoperative 5-FU group (40%). The use of intraoperative 5-FU exclusively as a mode of antimetabolite delivery seems an acceptable alternative to enhance success rates of trabeculectomy for the primary glaucomas.
对33例患者的33只眼睛进行前瞻性评估，以研究原发性青光眼初次小梁切除术联合术中及术后使用5-氟尿嘧啶（5-FU）的短期疗效和总体手术效果。12只眼睛作为对照组，接受了不使用辅助抗代谢药物的小梁切除术。11只眼睛术中使用5-FU，10只眼睛术后结膜下注射5-FU。术中及术后5-FU组分别有90.9%和80%的患者在随访3个月时眼压维持在22 mmHg以下，且无需使用额外的抗青光眼药物，而对照组66.7%的患者达到了相似的眼压水平。术中使用5-FU后低眼压（眼压<6 mmHg）更为常见（27.3%）。角膜上皮缺损仅出现在术后5-FU组（40%）。单纯将术中使用5-FU作为抗代谢药物的给药方式似乎是提高原发性青光眼小梁切除术成功率的一种可接受的替代方法。
