A randomized study of trabeculectomy and subconjunctival administration of fluorouracil in primary glaucomas
A. Ophir and U. Ticho
Department of Ophthalmology, Hadassah University Hospital, Jerusalem, Israel.
Forty-one adult patients with primary open angle glaucoma and nine adult
patients with chronic angle closure glaucoma underwent trabeculectomy in
one eye each. Twenty-one eyes with primary open angle glaucoma and four
with chronic angle closure glaucoma were randomly assigned to receive four
to six subconjunctival injections of fluorouracil for 10 days after
surgery. Twenty-five control eyes did not receive fluorouracil. Intraocular
pressure was 20 mm Hg or lower in 24 eyes (96%) in the treatment group
after mean follow-up of 17.8 months and in 19 control eyes (76%) after mean
follow-up of 17.5 months (P less than .05). Encapsulated bleb developed in
three (12%) of the fluorouracil-treated eyes vs two (8%) of the control
eyes. A few injections of fluorouracil adequately inhibited scarring. This
might be explained by its toxic effect on existing fibroblasts. Overall,
trabeculectomy with injection of fluorouracil was found to be efficacious
and relatively safe. Further studies regarding late complications are
required.
