Clinical Observation for Trabeculectomy with Mitomycin and 5-fluorouracil

Objective:Application of mitornycin C trabeculectomy,postoperative with 5-fluorouracil(5-Fu)treatment of glaucoma.Methods:42 patients(49 eyes)with glaucoma were randomly divided into two groups:A group of 23 eyes for the treatment group,to trabeculectomy with mitomycin,patients with 5-fluorouracil(5-Fu)subconjunctival injection.The other group was the control group with 26 eyes,to trabeculectomy only with mitomycin,afte not with 5-fluorouracil(5-Fu)treatment.Were followed up for six months to two years,eye patients before and after treatment visual acuity,intraocular pressure,bleb as well as shallow anterior chamber and low intraocular pressure and othe indicators of corneal damage,success rate and complications of surgery were compared.Results:Treatment group,visual acuity improved in 5 eyes(21.7%),not improved in 16 eyes(69.6%),decreased in 2 eyes(8.7%);The mean preoperative IOP(42.57±4.51)mmHg,the mean postoperative IOP(11.46±3.45)mmHg,Hypotony and shallow anterior chamber occurred in 5 eyes(21.7%),Corneal lesions in 4 eyes(17.4%),Hyphemain 1 eye(4.3%),subconjunctival hemorrhage,4 eyes(17.4%);Effective filtering bleb in 20 eyes(87.0%),invalid bleb 3 eyes(13.0%).The control group visual acuity improved in 4 eyes(15.4%),not improved in 19 eyes(73.1%),decreased in 3 eyes(11.5%);The mean preoperative IOP(43.23±5.12)mmHg,the mean postoperative IOP(13.35±4.63)mmHg,Hypotony and shallow anterior chamber occurred in 4 eyes(15.4%),Corneal lesions in 1 eyes(3.8%),Hyphemain 0 eye,subconjunctival hemorrhage,1 eyes(3.8%);Effective filtering bleb in 17 eyes(65.4%),invalid bleb 9 eyes(34.6%).Conclusion:Mitomycin and 5-Fu as adjuvant glaucoma filtering surgery can be reduced,the prevention of postoperative bleb recurrence of glaucoma caused by adhesions package,both can play a synergistic role in combination to improve the success rate of surgery.But after 5-Fu combined to increase the incidence of shallow anterior chamber with low intraocular pressure,in the same time the damage to the cornea while the corresponding increase pressure;If the merger taking systemic vasodilators can cause subconjunctival or anterior chamber bleeding complications;So it should be correct and reasonable use of mitomycin and 5-Fu,note that the timing of medication,dose and concentration.