Abstract
Filtering surgery, since introduced by de Wecker in 1889, has been performed to lower intraocular pressure and to prevent glaucomatous optic nerve damage. Although many variations on the size and shape of the fistula have been reported, only recently has attention turned to the modulation of the postoperative wound healing response. Efforts to alter wound healing and to promote filtering bleb formation were initially limited to eyes with a poor prognosis for success. Antimetabolites, such as 5-fluorouracil and mitomycin-C, have been demonstrated in clinical trials to enhance the success of filtering surgery in eyes with a worse-than-usual prognosis. The exact timing, administration schedule (intraoperative vs postoperative), dose, and selection of potential surgical candidates continue to be defined as follow-up results are monitored.
