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Titolo:
Low-dose 5-fluorouracil trabeculectomy as initial surgery in uncomplicatedglaucoma: Long-term followup
Autore:
Rothman, RF; Liebmann, JM; Ritch, R;
Indirizzi:
New York Eye & Ear Infirm, Glaucoma Serv, Dept Ophthalmol, New York, NY 10003 USA New York Eye & Ear Infirm New York NY USA 10003 l, New York, NY 10003 USA New York Med Coll, Valhalla, NY 10595 USA New York Med Coll Valhalla NY USA 10595 Med Coll, Valhalla, NY 10595 USA
Titolo Testata:
OPHTHALMOLOGY
fascicolo: 6, volume: 107, anno: 2000,
pagine: 1184 - 1190
SICI:
0161-6420(200006)107:6<1184:L5TAIS>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
BLEB-RELATED ENDOPHTHALMITIS; INTRAOPERATIVE SPONGE 5-FLUOROURACIL; ADJUNCTIVE MITOMYCIN-C; OPEN-ANGLE GLAUCOMA; FILTERING SURGERY; FILTRATION SURGERY; POSTOPERATIVE 5-FLUOROURACIL; PEDIATRIC GLAUCOMA; SUBCONJUNCTIVAL; FIBROBLASTS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
86
Recensione:
Indirizzi per estratti:
Indirizzo: Ritch, R New York Eye & Ear Infirm, Glaucoma Serv, Dept Ophthalmol, 310 E 14th St, New York, NY 10003 USA New York Eye & Ear Infirm 310 E 14th St NewYork NY USA 10003 USA
Citazione:
R.F. Rothman et al., "Low-dose 5-fluorouracil trabeculectomy as initial surgery in uncomplicatedglaucoma: Long-term followup", OPHTHALMOL, 107(6), 2000, pp. 1184-1190

Abstract

Objective: To compare the effectiveness of trabeculectomy with adjunctive,low-dose, subconjunctival 5-fluorouracil (5-FU) to trabeculectomy alone inpatients with uncomplicated glaucoma undergoing their first incisional surgical procedure. Design: Retrospective, nonrandomized comparative trial. Participants: Consecutive series of 52 patients and 74 control subjects,Intervention: Trabeculectomy was performed in all patients. Study patientsreceived adjunctive, subconjunctival injections of 5-FU up to 14 days fromthe date of surgery. Main Outcome Measures: Intraocular pressure, number of postoperative antiglaucoma medications, interventions, and complications were evaluated. Results: Mean followup for all patients was 58.1 +/- 44.1 months (range, 1.1-159.9 months), Mean followup for successful eyes was 55.9 +/- 47.1 months (range, 7.6-159.9 months), The cumulative 5-year success (intraocular pressure [IOP] less than or equal to 21 mmHg) was 77.8% in the 5-FU group and 62.2% in the control group (P = 0.02, Wilcoxon test. Complete success (IOP less than or equal to 21 mmHg without medications) at 5 years was lower in both the 5-FU group (72.3%) and the control group (51.3%). Postoperative mean IOP at 5 years for all successful patients was lower in eyes receiving 5-FU (10.7 +/- 3.6 mmHg vs. 16.0 +/- 6.1 mmHg [P = 0.02, t-test]). For thosepatients considered to be complete successes, there was no difference in IOP between the two groups of patients at any evaluated time interval, Patients in the 5-FU group were using 0.7 +/- 1.1 medications at final followup compared with 1.8 +/- 1.4 medications in the control group (P = < 0.0001, ttest), Bleb-related ocular infection occurred in 6.3% of patients and was more common in patients receiving 5-FU than controls (6 of 52 vs 2 of 74, respectively; P = 0.05, Fischer's exact test). Conclusions: Adjunctive, low-dose 5-FU at the time of initial surgery in uncomplicated glaucoma improves long-term IOP control and reduces the need for postoperative, antiglaucoma therapy, Eyes receiving 5-FU are at greater risk of developing late bleb-related ocular infection. Ophthalmology 2000;107:1184-1190 (C) 2000 by the American Academy of Ophthalmology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/11/20 alle ore 07:14:32