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

Abstract

To examine the effect of mitomycin c and 5-flurouracil on treatment outcomes following Ahmed glaucoma valve implantation.Retrospective consecutive case series.Fifty patients who received Ahmed glaucoma valve implantation from 1999 to 2013 in the San Francisco Veterans Administration Hospital.The +INJECTION group received intraoperative mitomycin c followed by postoperative mitomycin c and/or 5-flurouracil, whereas the -INJECTION group did not.Primary outcome was treatment success at 1?year post-implantation. Intraocular pressure, hypertensive phase, and the number of glaucoma medications were also examined.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).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.

View details for DOI 10.1111/ceo.12811

View details for Web of Science ID 000398058700006

View details for PubMedID 27490793