A prospective randomized trial comparing intraoperative 5-fluorouracil vs mitomycin C in primary trabeculectomy

Darrell Wudunn, Louis B. Cantor, Angelita M. Palanca-Capistrano, Joni Hoop, Nishat P. Alvi, Charles Finley, Vipul Lakhani, Alan Burnstein, Stephenie L. Knotts

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90 Scopus citations

Abstract

PURPOSE: To compare the safety and efficacy of intraoperative 5-fluorouracil (5-FU) or Intraoperative mitomycin C (MMC) in eyes undergoing primary trabeculectomy. DESIGN: Prospective double-masked randomized clinical trial. METHODS: One hundred fifteen eyes of 103 patients with uncontrolled intraocular pressure (IOP) despite maximally tolerated medical therapy or laser were prospectively randomized in a double-masked fashion to one of two treatment groups in a single institution setting. Subject's eyes underwent primary trabeculectomy with either topical 5-FU (50 mg/ml for 5 minutes) or topical MMC (0.2 mg/ml for 2 minutes). Primary outcome measures included the number of eyes achieving target pressures of 21, 18, 15, and 12 mm Hg at 6 and 12 months postoperatively. Secondary outcome measures included IOP, best-corrected visual acuity, complications, and interventions. RESULTS: Of the 115 eyes, 57 received 5-FU while 58 received MMC. A target IOP of 21 mm Hg at 6 months was achieved in 53 of 56 (95%) eyes in the 5-FU group and 54 of 57 (95%) eyes in the MMC group (P = 1.00). At 12 months, 45 of 48 (94%) eyes in the 5-FU group met a target IOP of 21 mm Hg while 48 of 54 (89%) eyes in the MMC group did (P = .49). The most common complications in each group were persistent choroidal effusions and bleb leak. CONCLUSION: Our study suggests that intraoperative topical 5-FU is at least as effective as intraoperative topical MMC in reducing IOP of eyes undergoing primary trabeculectomy.

Original languageEnglish (US)
Pages (from-to)521-528
Number of pages8
JournalAmerican Journal of Ophthalmology
Volume134
Issue number4
DOIs
StatePublished - Oct 1 2002

ASJC Scopus subject areas

  • Ophthalmology

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    Wudunn, D., Cantor, L. B., Palanca-Capistrano, A. M., Hoop, J., Alvi, N. P., Finley, C., Lakhani, V., Burnstein, A., & Knotts, S. L. (2002). A prospective randomized trial comparing intraoperative 5-fluorouracil vs mitomycin C in primary trabeculectomy. American Journal of Ophthalmology, 134(4), 521-528. https://doi.org/10.1016/S0002-9394(02)01627-6