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Effectiveness of intra-operative and post-operative use of 5-fluorouracil in trabeculectomy--a randomized clinical trial.

Author(s): Malla P, Karki P, Das H

Affiliation(s): Department of Ophthalmology, B P Koirala Institute of Health Sciences, Dharan, Nepal. prasannaashrestha@hotmail.com

Publication date & source: 2010-01, Nepal J Ophthalmol., 2(1):16-25.

Publication type: Comparative Study; Randomized Controlled Trial

INTRODUCTION: The success rate of trabeculectomy is limited by postoperative scarring. OBJECTIVE: To evaluate the effectiveness of intra-operative and post-operative use of 5-Fluorouracil (5-FU) in trabeculectomy. MATERIALS AND METHODS: Thirty consecutive eyes undergoing trabeculectomy were randomized systematically into 3 groups of ten patients each. Group A served as a control; in Group B intraoperative 5-FU was used, whereas Group C received post-operative sub-conjunctival 5-FU. The variables studied were pre- and post-operative intraocular pressure, post-operative bleb characteristics and complications. STATISTICS: Data were evaluated using the SPSS ver 10.0 program. ANOVA, paired t test and chi2 tests were performed. RESULTS: The means of age in years of patients in group A, B and C were 49 +/- 9.23, 56.50 +/- 8.39 and 52.10 +/- 8.96 respectively (p = 0.222). The means of pre-operative IOP in groups A, B and C were 37.80 +/- 10 mmHg, 42.00 +/- 11.22 mmHg and 29.40 +/- 12.82 mmHg respectively. The medians of pre-operative anterior chamber depth (ACD) in groups B and C were 3 and 2 in group A according to van Herrick's grading. The mean values of final IOP were 11.90 +/- 3.50, 11.70 +/- 4.24, 11.00 +/- 2.83 mmHg (p = 0.841). The median post-operative anterior chamber depth in all the groups was similar compared to the pre-operative anterior chamber depth (p = 0.510). The final bleb scores in all the groups were similar (p = 0.873). CONCLUSION: The intra-operative and post-operative use of 5-FU in trabeculectomy is almost equally effective in terms of IOP control and bleb characteristics.

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