Posters

Effect on intraocular pressure of preoperative sub-tenon injection of 5-Fluorouracil in chronic open-angle glaucoma

Poster Details

First Author: K. Mahmood PAKISTAN

Co Author(s):                        

Abstract Details

Purpose:

The application of pre-trabeculectomy 5-FU is a novel innovation in which instead of injecting the drug per-op or post-op for multiple times, it was used in a single dose, 2 days before the surgery in cases of chronic primary open-angle glaucoma. The patients were on maximum tolerated medical therapy (more than two topical eye drops) for minimum of three years. The idea behind was to achieve a safer IOP level and to avoid the complications of antimetabolites after trabeculectomy.

Setting:

Avicenna Medical College and Hospital ,Aadil Hospital Lahore Pakistan

Methods:

55 eyes of 38 patients were selected. All patients were having chronic open-angle glaucoma and were using 3 or more than three topical eye drops for at least 03 years. Pre-operative IOP was in the range 20-34 mm of Hg with medical therapy. 0.3 ml of 50mg/ml of 5-Flourouracil injection was given 6.0mm away from limbus at 12`0 clock meridian in the sub-tenon space. Routine fornix based trabeculectomy was performed on the 2nd day of the sub-tenon injection of 5-FU. Complication data was maintained and all complications were managed accordingly.

Results:

Target IOP of 14mm of Hg was achieved in 42 eyes, 08 eyes were given a single additional medication to achieve target IOP and in 05 cases the target IOP was not achieved. Visual acuity remained stable in 50 eyes, while it deteriorated in 05 eyes due to complication. Bleb morphology was remarkably avascular and moderately elevated which was qualified as a functional bleb. No signs of bleb thinning or blebitis was noted in the post-op period. Shallow anterior chamber resulted in immediately post-op days in 4 eyes which was managed accordingly. Only one eye got hypotony which was normalized after 2 weeks. No case required redo trabeculectomy or needling.

Conclusions:

This novel technique is unique and proved to be very effective in controlling the IOP in chronic POAG with failed maximum medical therapy. Bleb achieved was functional and avascular.Post-op complications are few as compraed to studies in which MMC was applied

Financial Disclosure:

NONE