Mitomycin C versus 5-fluorouracil in high-risk glaucoma filtering surgery. Extended follow-up

G J Katz; E J Higginbotham; P R Lichter; G L Skuta; D C Musch; T J Bergstrom; A T Johnson

doi:10.1016/S0161-6420(95)30875-5

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Mitomycin C versus 5-fluorouracil in high-risk glaucoma filtering surgery. Extended follow-up

Journal article

Peer reviewed

Mitomycin C versus 5-fluorouracil in high-risk glaucoma filtering surgery. Extended follow-up

G J Katz, E J Higginbotham, P R Lichter, G L Skuta, D C Musch, T J Bergstrom and A T Johnson

Ophthalmology (Rochester, Minn.), Vol.102(9), p.1263

09/1995

DOI: 10.1016/S0161-6420(95)30875-5

PMID: 9097762

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Abstract

To compare the outcome of filtering surgery in high-risk patients using intraoperative mitomycin C (MMC) versus postoperative 5-fluorouracil (5-FU). In a randomized clinical trial, the use of postoperative subconjunctival injections of 5-FU in 19 eyes of 19 patients was compared with a single intraoperative application of MMC in 20 eyes of 20 patients. All eyes were at high risk for failure of glaucoma filtering surgery. Follow-up ranged from 26 to 38 months (mean, 32.0 months). Three eyes in the MMC-treated group and two eyes in the 5-FU-treated group required subsequent surgery to control the IOP. Excluding these patients, intraocular pressure (IOP) averaged 9.0 +/- 4.9 mmHg in the MMC-treated eyes versus 16.3 +/- 4.6 mmHg in the 5-FU-treated eyes at the patient's last visit (P = 0.0003). Of the MMC-treated eyes, 81.3% had IOPs less than or equal to 12 mmHg compared with 26.7% of eyes in the 5-FU group (P = 0.0023). In the MMC-treated group, the average number of medications for IOP control at last visit was 0.5 +/- 0.8 compared with 1.6 +/- 1.3 in the 5-FU-treated group (P = 0.01). Late postoperative complications (those occurring more than 3 months after surgery) were similar for the two groups, with the exception of formation of a Tenon cyst in three of the eyes treated with MMC compared with none of the 5-FU-treated eyes. Eyes treated with MMC have lower IOP on fewer medications than eyes treated with 5-FU. Late postoperative complications are similar with the exception of an increased incidence of Tenon cyst formation in the MMC-treated eyes.

Follow-Up Studies

Intraocular Pressure

Humans

Middle Aged

Glaucoma - drug therapy

Male

Treatment Outcome

Glaucoma - surgery

Visual Acuity

Filtering Surgery

Antimetabolites, Antineoplastic - administration & dosage

Antibiotics, Antineoplastic - administration & dosage

Injections

Fluorouracil - administration & dosage

Female

Chemotherapy, Adjuvant

Mitomycin - administration & dosage

Postoperative Complications

Details

Title: Subtitle: Mitomycin C versus 5-fluorouracil in high-risk glaucoma filtering surgery. Extended follow-up
Creators: G J Katz - Department of Ophthalmology, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, USA
E J Higginbotham
P R Lichter
G L Skuta
D C Musch
T J Bergstrom
A T Johnson
Resource Type: Journal article
Publication Details: Ophthalmology (Rochester, Minn.), Vol.102(9), p.1263
Publisher: United States
DOI: 10.1016/S0161-6420(95)30875-5
PMID: 9097762
ISSN: 0161-6420
eISSN: 1549-4713
Language: English
Date published: 09/1995
Academic Unit: Ophthalmology and Visual Sciences
Record Identifier: 9983980394202771

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