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5FU vs 5FU With Viscoelastic Formulation for the Prevention of Scarring Post-trabeculectomy

This study has been completed.
Singapore Eye Research Institute
Nanchang University
Information provided by:
Singapore National Eye Centre Identifier:
First received: January 23, 2008
Last updated: May 11, 2010
Last verified: May 2010

Trabeculectomy is the most effective method of lowering intraocular pressure in glaucoma that is not well controlled with drop medication. The post-operative wound healing response remains the major barrier in surgical success. Scar tissue formation results in occlusion of the surgical drainage site created. As a consequence, the intraocular pressure rises once again. The current use of anti-scarring agents such as 5 Fluorouracil (5FU), is a well established method employed by ophthalmologists to clinically reduce the postoperative scarring response. However, in patients with a high risk of bleb failure, repeated subconjunctival injections of 5FU following bleb needling is often required resulting in increased clinical load and patient inconvenience. A slow release formulation of 5FU would be of benefit by releasing the 5FU into the subconjunctival space over an extended period thereby providing a prolonged therapeutic effect. In addition, hyaluronic acid is known to possess antifibrotic properties and from its gel-like physical state, would potentially act as a physical tissue spacer that may further limit active subconjunctival scarring at the site where it is injected. We hypothesise that injecting a mixture of 5FU with hyaluronic acid would give better outcomes than injecting 5FU alone.

The aim of this study is to determine whether bleb needling with subconjunctival injection of Viscoelastic/5FU formulation is an effective method for prolonged drug delivery in preventing the post-operative scarring response. This will be a prospective case-controlled study involving patients who have already undergone trabeculectomy and who require bleb needling and subconjunctival 5FU injections.

Condition Intervention Phase
Wound Healing
Drug: 5 Fluorouracil with hyaluronic acid
Drug: 5 Fluorouracil
Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Prospective Case-controlled Study Comparing 5-Fluorouracil vs 5-Fluorouracil With Viscoelastic (Hyaluronic Acid) Formulation for the Prevention of Subconjunctival Scarring Post-trabeculectomy

Resource links provided by NLM:

Further study details as provided by Singapore National Eye Centre:

Primary Outcome Measures:
  • intraocular pressure [ Time Frame: 12 weeks ]

Secondary Outcome Measures:
  • bleb morphology [ Time Frame: 12 weeks ]

Estimated Enrollment: 50
Study Start Date: February 2008
Study Completion Date: January 2010
Primary Completion Date: January 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: 1
The participants will receive a subconjunctival injection of a mixture of 5FU with hyaluronic acid.
Drug: 5 Fluorouracil with hyaluronic acid
Participants will receive a subconjunctival injection of 0.1ml of a mixure of 5 Fluorouracil (50mg/ml) with hyaluronic acid (23mg/ml) once at enrollment into the study.
Other Name: Healon 5 - hyaluronic acid 23mg/ml
Active Comparator: 2
Participants will receive a subconjunctival injection of 5 Fluorouracil only.
Drug: 5 Fluorouracil
Pariticpants will receive a subconjunctival injection of 0.1ml of 5 Fluorouracil 50mg/ml once at enrollment

  Show Detailed Description


Ages Eligible for Study:   21 Years to 90 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

Glaucoma patients within 1 year of the primary (first) trabeculectomy who are deemed on clinical grounds (increased bleb vascularity, bleb contraction or encapsulation or IOP elevation) to require a subconjunctival 5-FU injection.

Exclusion Criteria:

  1. Active or recent bleb leak
  2. Known hypersensitivity to 5-FU or HA
  3. Only eye
  4. Active or recent blebitis or endophthalmitis.
  5. Intraocular pressure less than 10.
  6. Inability to give informed consent.
  7. Inability to safely administer a subconjunctival injection
  8. Uncontrolled systemic hypertension, CVA or TIA within the previous month.
  9. Pregnancy
  Contacts and Locations
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Please refer to this study by its identifier: NCT00607685

Singapore National Eye Centre
Singapore, Singapore, 168751
Sponsors and Collaborators
Singapore National Eye Centre
Singapore Eye Research Institute
Nanchang University
Study Chair: Tina TL Wong, PhD Singapore National Eye Centre
  More Information

Responsible Party: Dr Tina Wong, Singapore National Eye Centre Identifier: NCT00607685     History of Changes
Other Study ID Numbers: R554/42/2007
Study First Received: January 23, 2008
Last Updated: May 11, 2010

Keywords provided by Singapore National Eye Centre:
Wound healing
5 Fluorouracil
Hyaluronic acid
post-operative scarring

Additional relevant MeSH terms:
Pathologic Processes
Hyaluronic Acid
Molecular Mechanisms of Pharmacological Action
Antimetabolites, Antineoplastic
Antineoplastic Agents
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Adjuvants, Immunologic
Protective Agents processed this record on May 22, 2017