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NR 4-6/2005
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Podspojówkowe
zastosowanie 5-fluorouracylu po leczeniu operacyjnym jaskry
metodą sklerektomii głębokiej – wskazania, powikłania, wstępna
ocena skuteczności
Subconjuctival application
of 5-fluorouracil (5-FU) following surgical treatment of
glaucoma with deep sclerectomy – indications, complications and
initial evaluation of efficacy
Małgorzata Wojtulewicz, Marek Rękas,
Joanna Wierzbowska
Z Kliniki Okulistyki Wojskowego Instytutu Medycznego w Warszawie
Kierownik: prof. dr hab. n. med. Andrzej Stankiewicz |
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| Summary: |
Purpose: 5-FU is an
antimetabolite which increases efficacy of deep
sclerectomy by inhibiting subconjuctival fibrosis and
fibroblast proliferation. The objective of the study was
to analyze glaucoma patients who had undergone
sclerectomy and in a post-surgery period required
subconjuctival 5-FU injections.
Material and methods: Out of 120 patients who had
undergone deep sclerectomy between January through
November 2004, 17 were included in the study since they
required subconjuctival 5-FU injections in a
post-operative period. The analysis comprised of: (1)
indications for antimetabolite administration; (2) time
that elapsed from the surgery to the first
antimetabolite administration; (3) mean dosage; (4)
complications observed; and (5) initial evaluation of
the treatment.
Results: In 13 patients (76.4%), the indication
for 5-FU application was persistent intraocular pressure
exceeding 15 mmHg; in one patient (5.8%), the 5-FU
treatment was started due to an abrupt increase of the
pressure from hypotony; in 6 subjects (35.2%), it was
the thickening and vascular dilatation in the filtering
bleb; in one subject (5.8%) encapsulated filtering bleb.
Mean time of administering 5-FU was between the 2nd and
3rd week following surgery. Mean number of injectctions
applied was 3.7 (18.5 mg 5-FU). The following
complications were encountered: corneal superficial
punctuate keratopathy (6 subjects), choroidal detachment
(1 person), irregular astigmatism (1 person). In most
cases IOP was well controlled by the end of the
follow-up period (Ł 15 mmHg).
Conclusions: 5-FU is safe and does not increase
the perioperative risk, and has turned out to be
effective in most cases of increased scarring in the
filtering bleb site. |
| Słowa kluczowe: |
jaskra, sklerektomia
głęboka, 5-fluorouracyl, dysfunkcja pęcherzyka
filtracyjnego. |
| Key words: |
glaucoma, deep sclerectomy,
5-fluorouracil, filtering bleb dysfunction. |
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