Long-term Outcomes of Intraoperative 5-Fluorouracil versus Intraoperative Mitomycin C in Primary Trabeculectomy Surgery

Palanca-Capistrano, Angelita M.; Hall, Jason F.; Cantor, Louis B.; Morgan, Linda; Hoop, Joni; WuDunn, Darrell

doi:10.1016/j.ophtha.2008.08.009

Cited by 154 publications

(108 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The risk of endophthalmitis with the use of antimetabolite agents is similar between MMC and 5-FU. 21,22 In our series of combined patients, none of the patients had bleb-related complications or endophthalmitis, although in all of the patients intraoperative MMC was used. In the Collaborative Initial Glaucoma Treatment Study of 285 trabeculectomy patients, the risk of endophthalmitis after 7 years was reported to be 1.1% (n ¼ 3), and there were 14% patients (n ¼ 40) requiring bleb revision.…”

Section: Discussionmentioning

confidence: 76%

Surgical outcome of safe surgery system trabeculectomy combined with cataract extraction

Raje¹,

Rathi

Agashe

et al. 2014

Eye

View full text Add to dashboard Cite

Purpose To determine the efficacy of safe surgery system trabeculectomy combined with manual small incision cataract surgery/ phacoemulsification in primary glaucoma coexistent with cataract. Methods This is a retrospective analysis of 105 cases who underwent single-site combined surgery between January 2008 and December 2009. Safe surgery system trabeculectomy with diffuse and posterior application of mitomycin C was performed in all cases. Cataract extraction was done either by Manual Small Incision Cataract Surgery (MSICS) or phacoemulsification. Main outcome measures were success rate of trabeculectomy, as determined by four different IOP goals and incidence of postoperative complications. Analysis was performed using R-2.15, and the significance was tested at 5% level. Results The minimum follow-up period was 12 months. The overall success rates (with or without medication) when safe surgery system trabeculectomy was combined with MSICS were 91, 70, and 51% for IOP r18, r15, and r12 mm Hg, respectively, and target IOP was achieved in 72% cases. The mean IOP reduction was 43.8% with MSICS and 42.08% with phacoemulsification. The surgical outcome was not significantly different for both techniques. Postoperative complications were infrequent and comparable. Conclusion The Safe Surgery System Trabeculectomy combined with cataract surgery offers excellent IOP control with minimal postoperative complications. It offers an effective and improved solution for primary glaucoma coexistent with cataract found in developing countries.

show abstract

Section: Discussionmentioning

confidence: 76%

Surgical outcome of safe surgery system trabeculectomy combined with cataract extraction

Raje¹,

Rathi

Agashe

et al. 2014

Eye

View full text Add to dashboard Cite

show abstract

“…[1][2][3][4][5][6][7][8][9][10] In various studies, adjunctive mitomycin-C (MMC) has been demonstrated to increase the success rate of trabeculectomy when compared with trabeculectomy alone or with postoperative 5-fluorouracil injections. 1,2,[11][12][13] Unfortunately, antimetabolite-augmented glaucoma surgery can be associated with a higher frequency of prolonged wound leaks, hypotony with choroidal effusions and maculopathy, thin avascular blebs, and/or bleb leaks with late infection.…”

Section: Introductionmentioning

confidence: 99%

“…1,2,[11][12][13] Unfortunately, antimetabolite-augmented glaucoma surgery can be associated with a higher frequency of prolonged wound leaks, hypotony with choroidal effusions and maculopathy, thin avascular blebs, and/or bleb leaks with late infection. 9,14,15 Recently, a new biodegradable porous collagen-glycosaminoglycan (GAG) copolymer matrix implant has been proposed for glaucoma surgery on the basis of animal experiments. [16][17][18] Ologen (OLO) collagen matrix (Aeon Astron Europe BV, Leiden, The Netherlands) is a biodegradable collagen-GAG implant, available in various shapes and dimensions, that may maintain the hypotensive effect in glaucoma surgery and enhance the healing in other selected ophthalmic surgeries (eg, pterygium or strabismus).…”

Section: Introductionmentioning

confidence: 99%

Biodegradable collagen matrix implant vs mitomycin-C as an adjuvant in trabeculectomy: a 24-month, randomized clinical trial

Cillino

Pace

Cillino

et al. 2011

Eye

106

View full text Add to dashboard Cite

Aim To verify the safety and efficacy of Ologen (OLO) implant as adjuvant compared with low-dosage mitomycin-C (MMC) in trabeculectomy. Methods This was a prospective randomized clinical trial with a 24-month follow-up. Forty glaucoma patients (40 eyes) were assigned to trabeculectomy with MMC or OLO. Primary outcome includes target IOP at r21, r17, and r15 mm Hg; complete (target IOP without medications), and qualified success (target IOP regardless of medications). Secondary outcomes include bleb evaluation, according to Moorfields Bleb Grading System (MBGS); spectral domain optical coherence tomography (SD-OCT) examination; number of glaucoma medications; and frequency of postoperative adjunctive procedures and complications. Results The mean preoperative IOP was 26.5 ( ± 5.2) in MMC and 27.3 ( ± 6.0) in OLO eyes, without statistical significance. One-day postoperatively, the IOP dropped to 5.2 ( ± 3.5) and 9.2 ( ± 5.5) mm Hg, respectively (P ¼ 0.009). The IOP reduction was significant at end point in all groups (P ¼ 0.01), with a mean IOP of 16.0 (±2.9) and 16.5 (±2.1) mm Hg in MMC and OLO, respectively. The rates and Kaplan-Meier curves did not differ for both complete and qualified success at any target IOP. The bleb height in OLO group was higher than MMC one (Po0.05). SD-OCT analysis of successful/ unsuccessful bleb in patients with or without complete success at IOP r17 mm Hg indicated a sensitivity of 83% and 73% and a specificity of 75% and 67%, respectively, for MMC and OLO groups. No adverse reaction to OLO was noted. Conclusions Our results suggest that OLO implant could be a new, safe, and effective alternative to MMC, with similar long-term success rate.

show abstract

“…WuDunn and colleagues [19,20] reviewed the results of 115 eyes of 103 patients who underwent trabeculectomy with intraoperative 5-FU or MMC and found no significant difference in terms of success or complication rates. In a comparative study of trabeculectomy performed with or without antifibrotic agent (5-FU), Rothman at al.…”

Section: Discussionmentioning

confidence: 99%

Three-Year Follow-Up of Trabeculectomy with 5-Fluorouracil

Lindemann

Plange²,

Kuerten³

et al. 2017

Ophthalmic Res

View full text Add to dashboard Cite

Purpose: To evaluate the long-term outcome of trabeculectomy with intra- and postoperative 5-fluorouracil (5-FU) application in glaucoma. Methods: Eighty-six patients with glaucoma planned for primary trabeculectomy with 5-FU and a minimum follow-up of 3 years were retrospectively analyzed. Success rates, postsurgical 5-FU injections, needling procedures, and complications were analyzed. Results: Mean intraocular pressure (IOP) decreased from 27.2 ± 6.7 to 13.2 ± 4.2 mm Hg at 1 year and 13.8 ± 3.7 mm Hg at the 3-year follow-up. The complete success rates (no IOP-lowering medication) were 83, 79, 73, and 45% at 1 year for IOP ≤21, ≤18, ≤16, and ≤12 mm Hg, respectively, and 64, 59, 56, and 20% for these criteria at 3 years. The average number of medications decreased from preoperatively 2.9 ± 1.4 to 0.2 ± 0.5 at 1 year and 0.7 ± 1.1 at 3 years. During the first 6 months, subconjunctival 5-FU injections were performed in 49 cases. Eleven patients underwent bleb needling during the first 6 months and 13 patients underwent the procedure between the 6th month and the 3rd year. Malignant glaucoma and bleb-related endophthalmitis occurred in 1 patient each. Conclusions: Trabeculectomy with 5-FU is an efficient surgical procedure for glaucoma treatment when combined with intensified postsurgical care.

show abstract

Long-term Outcomes of Intraoperative 5-Fluorouracil versus Intraoperative Mitomycin C in Primary Trabeculectomy Surgery

Cited by 154 publications

References 22 publications

Surgical outcome of safe surgery system trabeculectomy combined with cataract extraction

Surgical outcome of safe surgery system trabeculectomy combined with cataract extraction

Biodegradable collagen matrix implant vs mitomycin-C as an adjuvant in trabeculectomy: a 24-month, randomized clinical trial

Three-Year Follow-Up of Trabeculectomy with 5-Fluorouracil

Contact Info

Product

Resources

About