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Effects of 5-Flurouracil in the Silicone Ahmed Glaucoma Valve Implantation         
Effects of 5-Flurouracil in the Silicone Ahmed Glaucoma Valve Implantation
作者:赵平1, J… 文章来源:1沈阳市爱尔眼科医院 110003, 2Edwards S. Harkness Eye Institute, Department of Ophthalmology, Columbia University, New York, USA 点击数:952 更新时间:2006/6/24 6:20:05
Objective: To evaluate the effects of 5-flurouracil (5-FU) in the implantation of silicone plate (FP7 model) Ahmed glaucoma valve (AGV). Methods: Retrospective chart-review of the consecutive patients underwent FP7 AGV implantation by one surgeon (JCT) in one hospital (Edwards S. Harkness eye institute) from Mar. 2003 to Mar. 2006. Patients with age older than 18 at the date of surgery and follow-up more than 3 months were included in the study. Survival analysis up to 2.5 years was made. Surgical success was defined as IOP greater than 6 mmHg and less than 21 mmHg without additional glaucoma surgery or devastating complications. IOP and number of medications used at the post-op visits at day 1, 1 week, 1 month, 3 months, 6 months and every 6 months thereafter (up to 30 months) and complications were recorded and compared. Results: Sixteen out of 60 patients (26.7%) with FP7 implants had 5-FU injection. The mean number of postoperative days for the first injection was 81.4 and the median was 69.5 days. Injections were repeated 2.8 times on average. Mean IOP at the day of first injection was 22.1 mmHg. The percentage that had hypertensive phase in 5-FU injection group was much higher than that without 5-FU injection, nearly two times (81.3% vs 43.2%, P=0.00896). Patients using 5-FU injection had relatively higher IOP at all postoperative visits, but only at 3m and 6m were significantly different. The number of medications was also greater in 5-FU injection group since 3m postoperatively (except at 1.5y which was equal), but still has no statistical significance. Survival analysis showed that the cumulative success rate for 5-FU injection group was 85.6% at 32 months and 64.8% for non-5-FU injection group at 26 months (P=0.9281). No major complication was noted for 5-FU injection. Conclusions: 5-FU is used postoperatively during the hypertensive phase of AGV implantation, but seems not affect the clinical course very much. Prospective study is necessary to further evaluate its effect.
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