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A randomised trial of the effect of intraoperative 5-FU on the outcome of trabeculectomy in east Africa
  1. D Yorstona,
  2. P T Khawb
  1. aKikuyu Eye Unit, Kikuyu, Kenya, bWound Healing Research Unit and Glaucoma Unit, Moorfields Eye Hospital and Institute of Ophthalmology, 11–43 Bath Street, London EC1V 9EL, UK
  1. Mr David Yorston, Department of Epidemiology and International Eye Health, Institute of Ophthalmology, 11–43 Bath Street, London EC1V 9EL, UKe.cartwright{at}ucl.ac.uk

Abstract

AIMS To determine if intraoperative application of 5-fluorouracil (5-FU) improves the prognosis for trabeculectomy in east Africa.

METHODS 68 eyes with chronic open angle glaucoma were included in a randomised trial of intraoperative 5-FU versus placebo. Main outcome measures were intraocular pressures at 6 months and probability of failure at 2 years.

RESULTS 180 days after surgery the mean intraocular pressure (IOP) was 17.4 (SD 6.1) mm Hg in the placebo group and 16.9 (5.8) mm Hg in the 5-FU group. By 2 years after trabeculectomy, the probability of successful IOP control was 70.6% in the placebo group, and 88.8% in the 5-FU group. The placebo group was 2.18 times (95% CI 0.67 to 7.15) more likely to require additional IOP lowering procedures than the 5-FU group. Among patients followed for 2 years, 30% lost 0.3 logMAR units of visual acuity.

CONCLUSIONS Trabeculectomy in Africa has an acceptable success rate which may be enhanced by the use of intraoperative 5-FU. It is estimated that this would cost approximately £1.25 per trabeculectomy failure prevented.

  • trabeculectomy
  • 5-fluorouracil
  • Africa

https://doi.org/10.1136/bjo.85.9.1028

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