Hugger P., Jonas J. B.

Universitäts-Augenklinik der Fakultät für Klinische Medizin Mannheim der Universität Heidelberg

Objective: Retrospective study to assess the results of subkonjunctival 5- FU injections as treatment of early bleb failure after filtering glaucoma surgery.
Methods: The clinical interventional retrospective study included 15 patients (mean age: 67 ± 11), who underwent filtering glaucoma surgery (trabeculectomy:11, goniotrepanation: 2, bleb revision: 2) with (Mitomycin C: 6, 5-FU: 6) or without (3) the use of intraoperative antimetabolites, and who presented in the early postoperative period with increasing intraocular pressure and clinical signs indicating early failure of the bleb. Subconjunctival injections with 5-FU were performed in a concentration of mg/ml. The injection site was placed at the 12 o´clock position close to the filtering bleb. Injections were performed under topical anesthesia on a daily base as an outpatient procedure until intraocular pressure was controlled and the bleb appearance improved.
Results: The mean intraocular pressure decreased from 21,7 ± 7,5 to 13,6 ± 3,4 mmHg. The mean number of injections was 7,8 ± 2,7. In all eyes the intraocular pressures could be reduced to the individually defined target pressure.
Conclusions: 5-FU injections are a treatment option in order to save failing blebs in the immediate postoperative course following filtering glaucoma surgery. The procedure can be performed as an outpatient procedure. Patients have to be followed closely after surgery to identify the rise in pressure as early as possible.

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