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D. Siriwardena, B. Edmunds, R.P. Wormald, P.T. Khaw; National Survey of Antimetabolite Use in Glaucoma Surgery in the United Kingdom . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1182.
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Purpose: To assess the pattern of antimetabolite use in trabeculectomy surgery by all consultant Ophthalmologists in the United Kingdom (UK). Methods: A postal questionnaire of twelve questions regarding antimetabolite use in trabeculectomy surgery was sent to all 749 consultant Ophthalmologists in the UK. The consultants were asked to estimate the number of trabeculectomies performed per year, how often they used 5-Fluorouracil (5-FU) in primary and redo surgery, their usual method of administration of 5-FU, how often they used mitomycin (MMC) in primary and redo surgery and their usual dosage regimen of MMC. We also assessed factors that influenced their decision to use antimetabolites. Results: The response rate was high, with 82 % (615 out of 749) of consultants returning the questionnaire. Of the 533 consultants currently performing trabeculectomy, 18 % (98) never use antimetabolites. Most consultants (82%) use antimetabolites, but use them infrequently, with only 9% using antimetabolites in more than half their cases. The preferred antimetabolite is 5-FU rather than MMC: of the 435 consultants currently performing trabeculectomy surgery and using antimetabolites, 93% (402) use 5-FU and 41% (179) use MMC. Various factors influenced the decision to use or not use an antimetabolite, but experience of complications associated with their use was a factor for 34 % of consultants. Conclusions: This study reveals the current pattern of antimetabolite use in glaucoma surgery in the UK. The use of antimetabolites, particularly the use of MMC, seems to be lower than in America or Japan, where trabeculectomy with MMC is the preferred surgical procedure.
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