Effect of mitomycin c and 5-flurouracil adjuvant therapy on the outcomes of Ahmed glaucoma valve implantation.

Authors

Qi N Cui
Yen C Hsia
Shan C Lin
Robert L Stamper
Jennifer Rose-Nussbaumer
Nitisha Mehta
Travis C Porco
Ayman Naseri
Ying Han

Publication/Presentation Date

3-1-2017

Abstract

BACKGROUND: To examine the effect of mitomycin c and 5-flurouracil on treatment outcomes following Ahmed glaucoma valve implantation.

DESIGN: Retrospective consecutive case series.

PARTICIPANTS: Fifty patients who received Ahmed glaucoma valve implantation from 1999 to 2013 in the San Francisco Veterans Administration Hospital.

METHODS: The +INJECTION group received intraoperative mitomycin c followed by postoperative mitomycin c and/or 5-flurouracil, whereas the -INJECTION group did not.

MAIN OUTCOME MEASURES: Primary outcome was treatment success at 1 year post-implantation. Intraocular pressure, hypertensive phase, and the number of glaucoma medications were also examined.

RESULTS: Twenty-six patients/eyes in the +INJECTION group and 24 patients/eyes in the -INJECTION group were included. Treatment success was higher in the +INJECTION compared with the -INJECTION group (86 vs. 58%; P = 0.04). Intraocular pressure was lower in the +INJECTION compared with the -INJECTION group at 1, 3, 6 and 12 months (P ≪ 0.00001, P = 0.00003, 0.0008 and 0.024). Hypertensive phase occurred less often in the +INJECTION compared with the -INJECTION group (3.8 vs. 54%; P = 0.021). The +INJECTION group required fewer medications compared with the -INJECTION group (P = 0.02, 0.002, 0.003 and 0.008 at 1, 3, 6 and 12 months). Complication rates were comparable between groups (46.2 and 54.2%; P = 0.63).

CONCLUSIONS: Adjuvant treatment with antifibrotics following Ahmed glaucoma valve implantation decreased the hypertensive phase and improved surgical outcomes without impacting complication rates at 1 year. This study postulates a role for antifibrotics in the postoperative management of Ahmed glaucoma valves.

Volume

45

Issue

2

First Page

128

Last Page

134

ISSN

1442-9071

Published In/Presented At

Cui, Q. N., Hsia, Y. C., Lin, S. C., Stamper, R. L., Rose-Nussbaumer, J., Mehta, N., Porco, T. C., Naseri, A., & Han, Y. (2017). Effect of mitomycin c and 5-flurouracil adjuvant therapy on the outcomes of Ahmed glaucoma valve implantation. Clinical & experimental ophthalmology, 45(2), 128–134. https://doi.org/10.1111/ceo.12811

Disciplines

Medical Education | Medicine and Health Sciences

PubMedID

27490793

Department(s)

USF-LVHN SELECT Program, USF-LVHN SELECT Program Students

Document Type

Article