Document Detail


Long-term comparison of primary trabeculectomy with 5-fluorouracil versus mitomycin C in West Africa.
MedLine Citation:
PMID:  18854737     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To compare the long-term efficacy and safety of intraoperative 5-fluorouracil (5-FU) versus mitomycin-C (MMC) used adjunctively with primary trabeculectomy in a Black West African population. DESIGN: Retrospective comparative study supplemented with cross-sectional follow-up data. METHODS: Review of 68 eyes of 68 Black West African subjects that underwent primary trabeculectomy with the use of intraoperative 5-FU or MMC between January 1, 1988 and January 1, 2002 and had at least 3 years postoperative follow-up. Postoperative outcome measures included intraocular pressure (IOP) control, number of glaucoma medications, visual acuity, and complications. RESULTS: Thirty-eight of sixty-eight eyes received 5-FU and 30 received MMC. Mean postoperative follow-up was 7.5 and 6.5 years in the 5-FU and MMC groups, respectively (P=0.17). A higher proportion of eyes in the MMC group achieved "qualified" (with or without medical therapy) success with varying IOP targets relative to the 5-FU group, but the differences were not statistically significant. "Complete" (without medical therapy) postoperative success was greater in the MMC group with a significantly higher proportion achieving an IOP <21 mm Hg (P=0.02). MMC use was also associated with a lower likelihood of receiving IOP-lowering medications postoperatively (P=0.01). Baseline demographic characteristics, preoperative and postoperative IOP, visual acuity, and complications did not differ significantly between the 2 groups. CONCLUSIONS: Intraoperative MMC use is associated with a lower likelihood of requiring postoperative medications and a greater likelihood of achieving IOP lowering without medications relative to the use of 5-FU in a Black West African population.
Authors:
Hanna Y Kim; Peter R Egbert; Kuldev Singh
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of glaucoma     Volume:  17     ISSN:  1536-481X     ISO Abbreviation:  J. Glaucoma     Publication Date:    2008 Oct-Nov
Date Detail:
Created Date:  2008-10-15     Completed Date:  2009-01-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9300903     Medline TA:  J Glaucoma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  578-83     Citation Subset:  IM    
Affiliation:
Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA 97303, USA. hannakim@stanford.edu
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MeSH Terms
Descriptor/Qualifier:
African Continental Ancestry Group / ethnology
Aged
Antihypertensive Agents / therapeutic use
Antimetabolites / administration & dosage,  therapeutic use*
Combined Modality Therapy
Cross-Sectional Studies
Female
Fluorouracil / administration & dosage,  therapeutic use*
Follow-Up Studies
Ghana / epidemiology
Glaucoma, Open-Angle / drug therapy*,  ethnology,  surgery*
Humans
Intraocular Pressure
Male
Middle Aged
Mitomycin / administration & dosage,  therapeutic use*
Retrospective Studies
Trabeculectomy / methods*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Antimetabolites; 50-07-7/Mitomycin; 51-21-8/Fluorouracil

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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