Jampel H D, Thibault D, Leong K W, Uppal P, Quigley H A
Glaucoma Service, Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Invest Ophthalmol Vis Sci. 1993 Oct;34(11):3076-83.
To determine the effect of taxol and etoposide, hydrophobic drugs with antifibrosis activity, on the outcome of filtration surgery in glaucomatous monkeys.
Elevated intraocular pressure was produced bilaterally in eight cynomolgus monkeys by laser treatment of the trabecular meshwork. Four animals subconjunctivally received a polyanhydride disk containing 1 mg etoposide at the time of posterior lip sclerectomy in one eye; the other eye received an identical disk without drug. Similarly, four animals received a disk containing 50 micrograms of taxol in one eye and a blank disk in the other.
Eyes treated with taxol had lower intraocular pressures than control eyes from 20 days after surgery until death. Eyes with satisfactory filtration bleb appearance and patent fistulae on histologic examination had lower intraocular pressures. The intraocular pressure was lower and the duration of success longer in the etoposide-treated eyes (mean, 16 days) compared to that of the fellow eyes (mean, 10 days), but the difference was not statistically significant.
Use of polyanhydride disks containing taxol, but not etoposide, had a marked beneficial effect on intraocular pressure and bleb appearance after experimental filtration surgery in monkeys. The difference between the two agents may result from the greater antiproliferative potency of taxol and its greater duration of release from the polymer.
确定具有抗纤维化活性的疏水药物紫杉醇和依托泊苷对青光眼猴滤过手术效果的影响。
通过激光治疗小梁网，在八只食蟹猴双侧诱导眼压升高。四只动物在一只眼行后唇巩膜切除术时，结膜下植入含1毫克依托泊苷的聚酸酐盘；另一只眼植入不含药物的相同盘。同样，四只动物一只眼植入含50微克紫杉醇的盘，另一只眼植入空白盘。
从手术后20天直至死亡，用紫杉醇治疗的眼眼压低于对照眼。组织学检查显示滤过泡外观良好且瘘管通畅的眼眼压较低。与对侧眼（平均10天）相比，依托泊苷治疗的眼眼压较低且成功持续时间较长（平均16天），但差异无统计学意义。
在猴实验性滤过手术后，使用含紫杉醇而非依托泊苷的聚酸酐盘对眼压和滤过泡外观有显著有益影响。两种药物之间的差异可能源于紫杉醇更强的抗增殖效力及其从聚合物中释放的更长持续时间。
