Usage of 5-fluorouracil to prevent excessive scarring after hypotensive operations of non-penetrating type

Abstract

Objective. The effectiveness of topical application of 5-fluorouracil after antiglaucoma operations for the prevention of scarring of the formed outflow pathways of the intraocular fluid was analyzed. Methods. The study included 112 patients over 35 y.o. (125 eyes), operated for the primary open-angle glaucoma in the far-advanced stage in PCEM in 2015-2017. Patients were divided into two groups comparable in age, glaucoma stage, and pre-operation level of intraocular pressure (IOP): 1^st group - 57 patients (63 eyes) were undergone non-penetrating deep sclerectomy with 5 % 5-fluorouracil; 2^nd group - 55 patients (62 eyes) without 5-fluorouracil. Results. On the 7^th day after the operation there was the difference in IOP values between groups: when using antimetabolite they were significantly lower. On the 15^th day the difference in values significantly increased, and this tendency persisted for six months. By the 9^th months of observation average values of IOP in both groups was almost equal. In a year and a half there were two patients who did not need a laser descemetopuncture from the group used 5-fluorouracil, there were no such patients in the 2^nd group. Conclusions. Thus, the use of 5-fluorouracil in the form of injections is a safe way of preventing early scarring processes in the area of formed outflow pathways of the eye fluid, which significantly increases the effectiveness of antiglaucoma surgery.