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January 1986

Topical Fluorouracil: II. Postoperative Administration in an Animal Model of Glaucoma Filtering Surgery

Author Affiliations

From the Departments of Ophthalmology, University of Florida College of Medicine, Gainesville (Dr Heuer), the Bascom Palmer Eye Institute, University of Miami School of Medicine (Drs Gressel and Parrish), and the University of Iowa Hospitals and Clinics, Iowa City (Dr Folberg); and the Division of Comparative Pathology, Department of Pathology, University of Miami School of Medicine (Drs Dillberger and Altman). Dr Gressel is now with the Lorain (Ohio) Community Hospital.

Arch Ophthalmol. 1986;104(1):132-136. doi:10.1001/archopht.1986.01050130146041

• Unilateral posterior lip sclerectomies were performed in ten owl monkeys. Five milligrams of fluorouracil was injected subconjunctivally in each operated eye immediately after surgery. Three drops (approximately 2.4 mg/drop) of fluorouracil were instilled ten minutes apart in each operated eye twice daily on postoperative days 1 through 7 and once daily on postoperative days 8 through 15, 17, 19, and 21. One monkey died on the seventh postoperative day; its death could not be attributed to systemic fluorouracil toxicity. All of the operated eyes had filtering blebs after the full course of fluorouracil, but seven also had corneal epithelial defects. By the seventh postoperative week, two of the operated eyes manifested moderately severe corneal opacification. Ten weeks postoperatively, the electroretinographic a- and b-wave amplitudes averaged 17% and 12% less, respectively, in the seven operated eyes without clinically significant corneal opacification than in the unoperated fellow eyes. Only two eyes had blebs after the 12th postoperative week. Histopathologic examination was performed on five eyes, of which only two revealed patent sclerostomies. Although topical fluorouracil appears to delay bleb scarring, the corneal findings suggest that it may be more toxic than subconjunctival fluorouracil.

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