Intra-operative 5-FU in Glaucoma Surgery: A Nigerian Teaching Hospital Experience

Background: 5-Fluorouracil (5-FU) is an anti-metabolite used as an adjunct during the initial stages of a trabeculectomy to prevent excessive post-operative scarring and thus reduce the risk of failure. Objectives: To assess the effects of intra-operative 5-FU in trabeculectomy in Nigerians. Methods: Trabeculectomy with an intra-operative sponge soaked with 5-FU was performed in 49 eyes of 34 patients. The reduction in intra-ocular pressure (IOP), Visual acuity changes and complications were noted. Results: The mean presenting and preoperative IOP was 35.6+/-12.5mmHg and 25.5+/-6.6mmHg respectively. The mean post-operative IOP was 10.0+/- 5.2mmHg on the second post-operative day and 16.5+/7.3mmHg at 3 months. Post-operative complications included ocular hypotony in 4 (25 percent), shallowing of anterior chamber in 3 (18.8 percent), hyphema and cystic bleb in 2 (12.5 percent) each. None had bleb failure. 5 FU appears to reduce the relative risk of failure of trabeculectomy in those undergoing surgery for the first time (relative risk 0.29, 95 percent confidence interval 0.16 to 0.53). Conclusions: The use of 5-FU during trabeculectomy is associated with significant benefit in terms of intraocular pressure lowering beyond 3 months postoperatively. The results of surgery in Nigerian patients compare well with other reported series.