Dose, timing and frequency of subconjunctival 5-fluorouracil injections after glaucoma filtering surgery
Although adjunctive postoperative 5-fluorouracil (5-FU) injections are known to improve the success rate of glaucoma surgery, it is still unknown what dose, timing and frequency of application will give the best results with respect to the inhibition of postoperative scarring and intraocular pressur...
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| Veröffentlicht in: | Graefe's archive for clinical and experimental ophthalmology 2007-03, Vol.245 (3), p.369-375 |
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| creator | Reinthal, Eva Kristina Denk, Paul Oliver Grüb, Matthias Besch, Dorothea Bartz-Schmidt, Karl Ulrich |
| description | Although adjunctive postoperative 5-fluorouracil (5-FU) injections are known to improve the success rate of glaucoma surgery, it is still unknown what dose, timing and frequency of application will give the best results with respect to the inhibition of postoperative scarring and intraocular pressure regulation. We therefore designed the following retrospective investigation.
We studied 172 eyes from 172 patients who had undergone trabeculectomy with adjuvant 5-FU-therapy. Variations of dosage, timing and frequency were analysed retrospectively. Surgery was defined as a complete success when the patient reached an intraocular pressure under 21 mmHg and a reduction of 20% 12 months after the operation. A relative success was achieved with these criteria under additional local medication. Not reaching these postoperative criteria for a complete success was classified as failure.
On average, adjunctive 5-FU-treatment was started 4.6+/-5.85 days postoperatively. The injections contained between 2 mg and 5 mg FU, and the mean total dose was 26.6+/-13.2 mg (range 5-65 mg). Surgery on 94 patients (54.65%) was classified as "complete success", that on 25 patients (14.53%) was classified as "relative success" and that on 53 eyes (30.81%) was classified as "failure" 12 months (+/-3 months) postoperatively. The best results were obtained when the treatment started on or before the first postoperative day (68.0-71.4% complete success; P |
| doi_str_mv | 10.1007/s00417-006-0406-3 |
| format | Article |
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We studied 172 eyes from 172 patients who had undergone trabeculectomy with adjuvant 5-FU-therapy. Variations of dosage, timing and frequency were analysed retrospectively. Surgery was defined as a complete success when the patient reached an intraocular pressure under 21 mmHg and a reduction of 20% 12 months after the operation. A relative success was achieved with these criteria under additional local medication. Not reaching these postoperative criteria for a complete success was classified as failure.
On average, adjunctive 5-FU-treatment was started 4.6+/-5.85 days postoperatively. The injections contained between 2 mg and 5 mg FU, and the mean total dose was 26.6+/-13.2 mg (range 5-65 mg). Surgery on 94 patients (54.65%) was classified as "complete success", that on 25 patients (14.53%) was classified as "relative success" and that on 53 eyes (30.81%) was classified as "failure" 12 months (+/-3 months) postoperatively. The best results were obtained when the treatment started on or before the first postoperative day (68.0-71.4% complete success; P<0.05). In contrast, an increase in 5-FU dosage did not result in an increased success rate of trabeculectomy. None of the 172 patients suffered from vision-threatening complications such as endophthalmitis or hypotony maculopathy.
Early treatment with 5-FU significantly increases the success rates of filtering surgery.</description><identifier>ISSN: 0721-832X</identifier><identifier>EISSN: 1435-702X</identifier><identifier>DOI: 10.1007/s00417-006-0406-3</identifier><identifier>PMID: 17043809</identifier><language>eng</language><publisher>Germany: Springer Nature B.V</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Conjunctiva - drug effects ; Female ; Fluorouracil - administration & dosage ; Glaucoma ; Glaucoma - surgery ; Humans ; Immunosuppressive Agents - administration & dosage ; Injections ; Intraocular Pressure ; Male ; Middle Aged ; Ophthalmology ; Postoperative Care - methods ; Postoperative Complications ; Retrospective Studies ; Time Factors ; Trabeculectomy ; Treatment Outcome</subject><ispartof>Graefe's archive for clinical and experimental ophthalmology, 2007-03, Vol.245 (3), p.369-375</ispartof><rights>Springer-Verlag 2007</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c392t-7f4ae0c43569393685f805f2474ea5b196664483a8eafb01b2d3cb43642443d43</citedby><cites>FETCH-LOGICAL-c392t-7f4ae0c43569393685f805f2474ea5b196664483a8eafb01b2d3cb43642443d43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17043809$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Reinthal, Eva Kristina</creatorcontrib><creatorcontrib>Denk, Paul Oliver</creatorcontrib><creatorcontrib>Grüb, Matthias</creatorcontrib><creatorcontrib>Besch, Dorothea</creatorcontrib><creatorcontrib>Bartz-Schmidt, Karl Ulrich</creatorcontrib><title>Dose, timing and frequency of subconjunctival 5-fluorouracil injections after glaucoma filtering surgery</title><title>Graefe's archive for clinical and experimental ophthalmology</title><addtitle>Graefes Arch Clin Exp Ophthalmol</addtitle><description>Although adjunctive postoperative 5-fluorouracil (5-FU) injections are known to improve the success rate of glaucoma surgery, it is still unknown what dose, timing and frequency of application will give the best results with respect to the inhibition of postoperative scarring and intraocular pressure regulation. We therefore designed the following retrospective investigation.
We studied 172 eyes from 172 patients who had undergone trabeculectomy with adjuvant 5-FU-therapy. Variations of dosage, timing and frequency were analysed retrospectively. Surgery was defined as a complete success when the patient reached an intraocular pressure under 21 mmHg and a reduction of 20% 12 months after the operation. A relative success was achieved with these criteria under additional local medication. Not reaching these postoperative criteria for a complete success was classified as failure.
On average, adjunctive 5-FU-treatment was started 4.6+/-5.85 days postoperatively. The injections contained between 2 mg and 5 mg FU, and the mean total dose was 26.6+/-13.2 mg (range 5-65 mg). Surgery on 94 patients (54.65%) was classified as "complete success", that on 25 patients (14.53%) was classified as "relative success" and that on 53 eyes (30.81%) was classified as "failure" 12 months (+/-3 months) postoperatively. The best results were obtained when the treatment started on or before the first postoperative day (68.0-71.4% complete success; P<0.05). In contrast, an increase in 5-FU dosage did not result in an increased success rate of trabeculectomy. None of the 172 patients suffered from vision-threatening complications such as endophthalmitis or hypotony maculopathy.
Early treatment with 5-FU significantly increases the success rates of filtering surgery.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Conjunctiva - drug effects</subject><subject>Female</subject><subject>Fluorouracil - administration & dosage</subject><subject>Glaucoma</subject><subject>Glaucoma - surgery</subject><subject>Humans</subject><subject>Immunosuppressive Agents - administration & dosage</subject><subject>Injections</subject><subject>Intraocular Pressure</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Ophthalmology</subject><subject>Postoperative Care - methods</subject><subject>Postoperative Complications</subject><subject>Retrospective Studies</subject><subject>Time Factors</subject><subject>Trabeculectomy</subject><subject>Treatment Outcome</subject><issn>0721-832X</issn><issn>1435-702X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpdkU1LxDAQhoMouq7-AC8SPHiyOvlomx7Fb1jwouAtpGmydmkTTRph_71ZdkHwMpkhz7zMzIvQGYFrAlDfRABO6gKgKoDnwPbQjHBWFjXQj300g5qSQjD6cYSOY1xBxllJDtERqXMmoJmhz3sfzRWe-rF3S6xch20w38k4vcbe4pha7d0qOT31P2rAZWGH5INPQel-wL1bmfzjXcTKTibg5aCS9qPCth9yvdGMKSxNWJ-gA6uGaE537xy9Pz683T0Xi9enl7vbRaFZQ6eitlwZ0HnOqmENq0RpBZSW8pobVbakqaqKc8GUMMq2QFraMd1yVnHKOes4m6PLre5X8HmPOMmxj9oMg3LGpyjzaVgpqMjgxT9wlddyeTZJGQggVV1miGwhHXyMwVj5FfpRhbUkIDceyK0HMnsgNx5IlnvOd8KpHU3317E7OvsFqV-CQQ</recordid><startdate>20070301</startdate><enddate>20070301</enddate><creator>Reinthal, Eva Kristina</creator><creator>Denk, Paul Oliver</creator><creator>Grüb, Matthias</creator><creator>Besch, Dorothea</creator><creator>Bartz-Schmidt, Karl Ulrich</creator><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20070301</creationdate><title>Dose, timing and frequency of subconjunctival 5-fluorouracil injections after glaucoma filtering surgery</title><author>Reinthal, Eva Kristina ; Denk, Paul Oliver ; Grüb, Matthias ; Besch, Dorothea ; Bartz-Schmidt, Karl Ulrich</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c392t-7f4ae0c43569393685f805f2474ea5b196664483a8eafb01b2d3cb43642443d43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Conjunctiva - drug effects</topic><topic>Female</topic><topic>Fluorouracil - administration & dosage</topic><topic>Glaucoma</topic><topic>Glaucoma - surgery</topic><topic>Humans</topic><topic>Immunosuppressive Agents - administration & dosage</topic><topic>Injections</topic><topic>Intraocular Pressure</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Ophthalmology</topic><topic>Postoperative Care - methods</topic><topic>Postoperative Complications</topic><topic>Retrospective Studies</topic><topic>Time Factors</topic><topic>Trabeculectomy</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Reinthal, Eva Kristina</creatorcontrib><creatorcontrib>Denk, Paul Oliver</creatorcontrib><creatorcontrib>Grüb, Matthias</creatorcontrib><creatorcontrib>Besch, Dorothea</creatorcontrib><creatorcontrib>Bartz-Schmidt, Karl Ulrich</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Graefe's archive for clinical and experimental ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Reinthal, Eva Kristina</au><au>Denk, Paul Oliver</au><au>Grüb, Matthias</au><au>Besch, Dorothea</au><au>Bartz-Schmidt, Karl Ulrich</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dose, timing and frequency of subconjunctival 5-fluorouracil injections after glaucoma filtering surgery</atitle><jtitle>Graefe's archive for clinical and experimental ophthalmology</jtitle><addtitle>Graefes Arch Clin Exp Ophthalmol</addtitle><date>2007-03-01</date><risdate>2007</risdate><volume>245</volume><issue>3</issue><spage>369</spage><epage>375</epage><pages>369-375</pages><issn>0721-832X</issn><eissn>1435-702X</eissn><abstract>Although adjunctive postoperative 5-fluorouracil (5-FU) injections are known to improve the success rate of glaucoma surgery, it is still unknown what dose, timing and frequency of application will give the best results with respect to the inhibition of postoperative scarring and intraocular pressure regulation. We therefore designed the following retrospective investigation.
We studied 172 eyes from 172 patients who had undergone trabeculectomy with adjuvant 5-FU-therapy. Variations of dosage, timing and frequency were analysed retrospectively. Surgery was defined as a complete success when the patient reached an intraocular pressure under 21 mmHg and a reduction of 20% 12 months after the operation. A relative success was achieved with these criteria under additional local medication. Not reaching these postoperative criteria for a complete success was classified as failure.
On average, adjunctive 5-FU-treatment was started 4.6+/-5.85 days postoperatively. The injections contained between 2 mg and 5 mg FU, and the mean total dose was 26.6+/-13.2 mg (range 5-65 mg). Surgery on 94 patients (54.65%) was classified as "complete success", that on 25 patients (14.53%) was classified as "relative success" and that on 53 eyes (30.81%) was classified as "failure" 12 months (+/-3 months) postoperatively. The best results were obtained when the treatment started on or before the first postoperative day (68.0-71.4% complete success; P<0.05). In contrast, an increase in 5-FU dosage did not result in an increased success rate of trabeculectomy. None of the 172 patients suffered from vision-threatening complications such as endophthalmitis or hypotony maculopathy.
Early treatment with 5-FU significantly increases the success rates of filtering surgery.</abstract><cop>Germany</cop><pub>Springer Nature B.V</pub><pmid>17043809</pmid><doi>10.1007/s00417-006-0406-3</doi><tpages>7</tpages></addata></record> |
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| identifier | ISSN: 0721-832X |
| ispartof | Graefe's archive for clinical and experimental ophthalmology, 2007-03, Vol.245 (3), p.369-375 |
| issn | 0721-832X 1435-702X |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Aged Aged, 80 and over Conjunctiva - drug effects Female Fluorouracil - administration & dosage Glaucoma Glaucoma - surgery Humans Immunosuppressive Agents - administration & dosage Injections Intraocular Pressure Male Middle Aged Ophthalmology Postoperative Care - methods Postoperative Complications Retrospective Studies Time Factors Trabeculectomy Treatment Outcome |
| title | Dose, timing and frequency of subconjunctival 5-fluorouracil injections after glaucoma filtering surgery |
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