Mitomycin C and 5-fluorouracil antimetabolite therapy for pediatric glaucoma filtration surgery.

Abstract

PURPOSE:

To evaluate the efficacy and safety of augmented trabeculectomy with 5-fluorouracil (5-FU) and mitomycin C (MMC) compared to 5-FU only for the treatment of pediatric glaucoma.

PATIENTS AND METHODS:

In a prospective randomized clinical trial, 8 children (12 eyes) with pediatric glaucoma, either congenital or secondary to: lens aspiration, Sturge-Weber syndrome, or steroids underwent augmented trabeculectomy. Six patients (8 eyes) underwent augmented trabeculectomy with 5-FU plus MMC and 2 patients (4 eyes) underwent augmented trabeculectomy with 5-FU only.

MAIN OUTCOME MEASURES:

Between-group comparison of postoperative parameters: change in intraocular pressure (IOP), dependence on antiglaucoma medication, number of 5-FU injections, cup-disc ratio, corneal diameter, drug-induced complications.

RESULTS:

In the 5-FU/MMC group, 7/8 eyes showed good control of postoperative IOP (9-16 mm Hg), which was independent of antiglaucoma therapy; only 2 injections of 5-FU were needed. By contrast, in the 5-FU group, no control of the postoperative IOP (21-23 mm Hg) was achieved in 4/4 eyes, and these patients remained dependent on antiglaucoma medication; up to 6 injections of 5-FU were used. There was no deterioration in the cup-disc ratio or the corneal diameter in either group. Results were maintained on follow-up (23-27 months). No significant drug-induced complications were noted.

CONCLUSION:

Augmented trabeculectomy with adjunctive 5-FU/MMC may be an option for the control of pediatric glaucoma in patients with a poor surgical prognosis.

• Authors: M Snir, M Lusky, B Shalev, D Gaton, D Weinberger
• Journal: Ophthalmic surgery and lasers (Ophthalmic Surg Lasers) 2000 Jan-Feb Vol. 31 Issue 1 Pg. 31-7 ISSN: 1082-3069 [Print] United States
• PMID: 10976558 (Publication Type: Clinical Trial, Comparative Study, Evaluation Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Alkylating Agents
• Antimetabolites
• Mitomycin
• Fluorouracil

Topics

• Alkylating Agents (administration & dosage)
• Antimetabolites (administration & dosage)
• Child, Preschool
• Drug Administration Routes
• Female
• Fluorouracil (administration & dosage)
• Glaucoma (etiology, surgery)
• Humans
• Infant
• Intraocular Pressure (physiology)
• Male
• Mitomycin (administration & dosage)
• Postoperative Complications (prevention & control)
• Prospective Studies
• Safety
• Trabeculectomy
• Visual Acuity