5-FLUOROURACIL AND MITOMYCIN-C IN PSEUDOPHAKIC PATIENTS

Purpose: Previous studies have shown that 5-fluorouracil (5-FU) and mitomycin C enhance the success rate of filtration surgery in aphakic eyes. However, eyes with posterior chamber implants have not been specifically studied. This study was performed to compare the safety and efficacy of 5-FU with that of mitomycin C in eyes that have posterior chamber implants and undergo filtration surgery for uncontrolled glaucoma. Methods: Eighty eyes of 74 patients who had previous cataract surgery with posterior chamber implants and who subsequently required trabeculectomy for uncontrolled open-angle glaucoma were randomized to receive either subconjunctival postoperative 5-FU or intraoperative mitomycin C. Results: Twelve months after surgery, intraocular pressures (IOPs) averaged 12.8 +/- 5.5 mmHg (mean +/- standard deviation) in the mitomycin C group and 14.8 +/- 3.8 mmHg in the 5-FU group (P = 0.001). Mitomycin C-treated eyes received an average of 0.6 medications for IOP control, and 5-FU-treated eyes received an average of 1.05 medications (P = 0.03). There was no significant difference in complications between the two groups. Conclusion: Mitomycin C appears be a viable alternative to 5-FU in patients with posterior chamber implants with uncontrolled glaucoma who require filtration surgery.