Borhani H, Peyman G A, Rahimy M H, Thompson H
LSU Eye Center, Louisiana State University Medical Center School of Medicine, New Orleans, USA.
Int Ophthalmol. 1995;19(1):43-9. doi: 10.1007/BF00156419.
Treatment of proliferative vitreoretinopathy (PVR) requires a multidimensional approach. Recent studies have focused on pharmacologic techniques to inhibit intraocular cell proliferation by applying antimetabolite drugs. Side effects associated with these drugs and difficulties in achieving effective concentration inside the eye make drug delivery an important and difficult part of this approach. We have developed a sustained-release bioerodible device with modifiable release properties for intraocular drug delivery. In this study, we evaluated the efficacy of the device with two different concentrations of 5-fluorouracil (5-FU) in an experimental model of PVR in rabbit eyes. Both devices showed significant (P < 0.05) efficacy in prevention of PVR. Devices containing 20% 5-FU (total of 1 mg) were 100% effective in prevention of tractional retinal detachment. No significant complications, other than mild vitreous hemorrhage in a few cases, were associated with this method. Because pharmacologic therapy is used as an augmenting method to surgical therapy, these devices can be easily implanted inside the eye through a sclerotomy at the completion of surgery without any discomfort to patients. Slow release of drug by this method reduces the incidence of toxicity and increases the efficacy by providing a constant concentration of drug during the active period of the disease.
增殖性玻璃体视网膜病变（PVR）的治疗需要采取多维度方法。近期研究聚焦于通过应用抗代谢药物来抑制眼内细胞增殖的药理学技术。与这些药物相关的副作用以及在眼内达到有效浓度的困难使得药物递送成为该方法的一个重要且困难的部分。我们开发了一种具有可调节释放特性的用于眼内药物递送的缓释生物可蚀性装置。在本研究中，我们在兔眼PVR实验模型中评估了含有两种不同浓度5-氟尿嘧啶（5-FU）的该装置的疗效。两种装置在预防PVR方面均显示出显著（P < 0.05）疗效。含有20% 5-FU（总量1毫克）的装置在预防牵引性视网膜脱离方面100%有效。除少数病例出现轻度玻璃体出血外，该方法未引起明显并发症。由于药物治疗用作手术治疗的辅助方法，这些装置可在手术完成时通过巩膜切开术轻松植入眼内，且不会给患者带来任何不适。通过这种方法缓慢释放药物可降低毒性发生率，并通过在疾病活跃期提供恒定药物浓度来提高疗效。
