In cases of refractory glaucoma, when Molteno shunt implantation has been performed and resulted in failure, the best surgical option has not yet been established. Filtering surgery with 5-fluorouracil (5-FU) as one option for the above was performed in four non-neovascular glaucomatous eyes (four patients) after failure of Molteno shunt implantation. Injections of 5 mg 5-FU were administered once daily for 9-14 days. After follow-up of 6-18 months in 3 eyes, intraocular pressure ranged from 10 to 16 mm Hg. In the fourth eye, in which bleb scarring ensued, a second filtering surgery with 5-FU was performed after 4 months, and resulted in a successful outcome as recorded 26 months later. These preliminary results suggest that filtering surgery with 5-FU might be an acceptable surgical option in non-neovascular refractory glaucoma subsequent to failure of Molteno shunt implantation.
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