Watts P, Karia N, McAllister J
Prince Charles Eye Unit, King Edward VII Hospital, Windsor, UK.
Eye (Lond). 1998;12 ( Pt 3a):374-8. doi: 10.1038/eye.1998.89.
To study the efficacy of the adjunctive use of a single intraoperative application of 5-fluorouracil (5FU) in eyes with poor prognoses for a successful outcome with a trabeculectomy.
Twenty-four patients (25 eyes) with a mean age of 63.7 +/- 14.7 years (range 27-86 years) and a history of one or more risk factors (age < 50 years, more than 3 years on topical medication, a previous failed filter, previous cataract surgery, uveitis, neovascular glaucoma) underwent trabeculectomy with the intraoperative application of 5FU on a sponge (25 mg/ml) for 5 min. The average follow-up was 10.1 +/- 5.5 months.
The mean pre-operative intraocular pressure (IOP) was 24.7 +/- 6.2 mmHg and the mean post-operative IOP was 13.9 +/- 3.5 mmHg. Success, defined as an IOP within desired target levels for a particular eye, in the presence of a functioning filter, without supplementary medical therapy, was achieved in 56.5% of cases.
Our results of successful filters in this group of patients with moderate- to high-risk characteristics approach similar figures quoted for trabeculectomies without the adjunctive use of intraoperative 5FU in eyes with poor prognoses with a similar length of follow-up. Though the numbers are small there is a trend that indicates that the intraoperative application of a single dose of 5FU alone may not be sufficient in eyes with moderate- to high-risk characteristics of failure of a trabeculectomy.
研究术中单次应用5-氟尿嘧啶（5FU）辅助小梁切除术对预后不良的患眼取得成功手术效果的疗效。
24例患者（25只眼），平均年龄63.7±14.7岁（范围27 - 86岁），有一个或多个危险因素（年龄<50岁、局部用药超过3年、既往滤过手术失败、既往白内障手术史、葡萄膜炎、新生血管性青光眼），接受小梁切除术，术中在海绵上应用5FU（25mg/ml）5分钟。平均随访时间为10.1±5.5个月。
术前平均眼压（IOP）为24.7±6.2mmHg，术后平均眼压为13.9±3.5mmHg。在56.5%的病例中获得成功，成功定义为在特定眼中眼压处于期望的目标水平，滤过功能良好，无需辅助药物治疗。
在这组具有中高风险特征的患者中，我们成功滤过的结果接近在随访时间相似的预后不良患眼中未术中应用5FU辅助的小梁切除术所引用的类似数据。尽管病例数较少，但有一个趋势表明，对于具有小梁切除术失败中高风险特征的患眼，单纯术中单次应用5FU可能是不够的。
