Longterm outcome of primary glaucoma triple procedure with adjunctive 5-fluorouracil

Purpose: To evaluate the long-term effect of adjunctive subconjunctival 5-fluorouracil (5-FU) on the filtration outcome of primary glaucoma triple procedure (PGTP) in primary open-angle glaucoma (POAG) patients. Methods: Seventy-four POAG patients were randomly assigned to PGTP alone (36 patients) or PGTP with adjunctive subconjunctival 5-FU (5.0±1.3 injections of 5 mg each, total of 24.8 mg) (38 patients). After surgery, the patients were examined at regular intervals for intraocular pressure (IOP), visual acuity, medical therapy requirements, and complications. Surgical success was defined as IOP ≤20 mmHg on postoperative medication ≤1 without additional glaucoma surgery. Results: Over an average follow-up (±SD) of 45.3 ± 25.0 months, both 5-FU and control groups maintained significant improvement of IOP control and visual acuity. However, there were no statistically significant differences between the 5-FU and control groups with respect to postoperative IOP, number of glaucoma medications, visual acuity outcome, and success rate overall or in selected patients with one or more of the risk factors for filtration failure. Conclusions: The use of low-dose subconjunctival 5-FU (mean dosage of 24.8 mg in 5.0 ± 1.3 injections) as an adjunct did not significantly improve the long-term filtration outcome of PGTP in POAG patients.