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Article
November 1994

Corneal Endothelial Toxic Effect Secondary to Fluorouracil Needle Bleb Revision

Author Affiliations

Southfield, Mich

Arch Ophthalmol. 1994;112(11):1411. doi:10.1001/archopht.1994.01090230025011

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Abstract

Needle revision with and without fluorouracil (5-fluorouracil) has been shown to be an effective procedure for the treatment of failed filtering blebs.1 Although several complications have been reported with the use of fluorouracil as an adjuvant to glaucoma filtering procedures, they are primarily related to the corneal epithelium.2 Little is known about the effects of this antimetabolite on the corneal endothelium. We recently treated two patients who underwent needle bleb revision with fluorouracil and in whom severe but reversible corneal edema subsequently developed.

Report of Cases. 

Case 1.  In February 1992, a 52-year-old phakic black man with chronic end-stage open angle glaucoma underwent a trabeculectomy without antimetabolite. Because of early bleb fibrosis, a bleb needling procedure was performed. An insulin syringe (a small-gauge needle) was introduced subconjunctivally into the bleb area and then swept under the scleral flap to lyse adhesions. The needle was then withdrawn slightly and

References
1.
Shin DH, Juzych MS, Khatana AK, Swendris RP, Parrow KA.  Needling revision of failed filtering blebs with adjunctive 5-fluorouracil . Ophthalmic Surg . 1993;24:242-248.
2.
The Fluorouracil Filtering Study Group.  Three-year follow-up of the fluorouracil filtering surgery study . Am J Ophthalmol . 1993;115:82-92.
3.
Weckbecker G.  Biochemical pharmacology and analysis of fluoropyrimidines alone and in combination with modulators . Pharm Ther . 1991;50:367-424.Article
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