Five-year follow-up of the Fluorouracil Filtering Surgery Study. The Fluorouracil Filtering Surgery Study Group

The Fluorouracil Filtering Surgery Study Group; Wallace L Alward; Thomas   Farrell; Sohan S Hayreh; Hansjoerg Kolder; Benita Carney; Charles Phelps

doi:10.1016/s0002-9394(14)70431-3

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Five-year follow-up of the Fluorouracil Filtering Surgery Study. The Fluorouracil Filtering Surgery Study Group

Journal article

Open access

Peer reviewed

Five-year follow-up of the Fluorouracil Filtering Surgery Study. The Fluorouracil Filtering Surgery Study Group

The Fluorouracil Filtering Surgery Study Group, Wallace L Alward, Thomas Farrell, Sohan S Hayreh, Hansjoerg Kolder, Benita Carney and Charles Phelps

American journal of ophthalmology, Vol.121(4), pp.349-366

04/1996

DOI: 10.1016/s0002-9394(14)70431-3

PMID: 8604728

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Abstract

To determine the efficacy and safety of subconjunctival 5- fluorouracil injections after trabeculectomy in patients with poor prognoses, to determine risk factors for surgical failure and to examine the relationship of intraocular pressure and visual function. In this multicenter clinical trial, 213 patients with previous cataract surgery or previous failed filtering surgery were randomly assigned to receive either trabeculectomy alone or trabeculectomy with postoperative subconjunctival 5-fluorouracil injections. Measurements of intraocular pressure, visual acuity, and visual fields were performed throughout the five years, with the clinician masked to the treatment group. Failure was defined as a reoperation to control intraocular pressure or an intraocular pressure greater than 21 mm Hg at or after the first-year examination. Fifty-four (51%) of the 105 eyes in the 5-fluorouracil group and 80 (74%) of the 108 eyes in the standard filtering surgery group were classified as failures (P < .001, Mantel-Cox survival analysis). Risk factors for failure include high intraocular pressure, a short time interval after the last procedure involving a conjunctival incision, the number of procedures with conjunctival incisions, and Hispanic ethnicity. Patients in both treatment groups with controlled intraocular pressures were more likely to maintain visual acuity. Patients in the 5-fluorouracil group had a higher risk of late-onset bleb leaks (9% nine of 105) than those in the standard filtering surgery group (2% two of 108) (P = .032, Fisher's exact test). We recommend the use of subconjunctival 5-fluorouracil after trabeculectomy in eyes after previous cataract surgery or unsuccessful filtering surgery, but caution against its routine use in patients with good prognoses.

Trabeculectomy

Follow-Up Studies

Cataract Extraction

Intraocular Pressure

Humans

Immunosuppressive Agents - therapeutic use

Middle Aged

Risk Factors

Visual Acuity

Fluorouracil - therapeutic use

Visual Fields

Treatment Failure

Survival Analysis

Glaucoma - therapy

Chemotherapy, Adjuvant

Details

Title: Subtitle: Five-year follow-up of the Fluorouracil Filtering Surgery Study. The Fluorouracil Filtering Surgery Study Group
Creators: The Fluorouracil Filtering Surgery Study Group (Author)
Wallace L Alward (Contributor) - University of Iowa, Ophthalmology and Visual Sciences
Thomas Farrell (Contributor)
Sohan S Hayreh (Contributor) - University of Iowa, Ophthalmology and Visual Sciences
Hansjoerg Kolder (Contributor)
Benita Carney (Contributor)
Charles Phelps (Contributor)
Resource Type: Journal article
Publication Details: American journal of ophthalmology, Vol.121(4), pp.349-366
Publisher: United States
DOI: 10.1016/s0002-9394(14)70431-3
PMID: 8604728
ISSN: 0002-9394
eISSN: 1879-1891
Grant note: EY05480 / NEI NIH HHS EY05473 / NEI NIH HHS EY10900 / NEI NIH HHS
Language: English
Date published: 04/1996
Academic Unit: Ophthalmology and Visual Sciences
Record Identifier: 9983979915902771

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