Survey of Ophthalmology
Volume 48, Issue 3 , Pages 314-346, May 2003

Antifibrotics and Wound Healing in Glaucoma Surgery☆

  • Paul J Lama, MD

      Affiliations

    • Corresponding Author InformationReprint address: Paul J. Lama, MD, Assistant Professor, Department of Ophthalmology, New Jersey Medical School, 90 Bergen Street, Suite 6100, Newark, NJ 07103
    • ,
  • Robert D Fechtner, MD

Glaucoma Division, New Jersey Medical School, Newark, N J, USA

MARCO ZARBIN AND DAVID CHU, EDITORS

Abstract 

When medical and laser therapy fail to control intraocular pressure, glaucoma filtration surgery needs to be performed. Glaucoma surgery is unique in that its success is linked to interruption of the wound-healing response in order to maintain patency of the new filtration pathway. In this article we will review the wound-healing pathway and the pharmacologic interventions that have been employed clinically and experimentally to interrupt wound healing, particularly steroids and the antifibrotic agents 5-fluorouracil and mitomycin C. A review of the published literature looking at use of these agents to enhance success as well as the associated complications are presented, critiqued, and interpreted in order to put the studies in proper perspective. Future directions and recommendations regarding use of these agents are available and an introduction to newer wound modulating agents such as anti-transforming growth factor beta 2 is presented.

Keywords:  5-fluorouracil, complications, glaucoma surgery, mitomycin C, trabeculectomy, wound healing

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☆ Supported in part by unrestricted grants from Research to Prevent Blindness and The Glaucoma Research and Education Foundation. The authors reported no proprietary or commercial interest in any product mentioned or concept discussed in this article.

PII: S0039-6257(03)00038-9

doi:10.1016/S0039-6257(03)00038-9

Survey of Ophthalmology
Volume 48, Issue 3 , Pages 314-346, May 2003

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