SUPPRESSION OF EXPERIMENTAL PROLIFERATIVE VITREORETINOPATHY BY SUSTAINED INTRAOCULAR DELIVERY OF 5-FU

Treatment of proliferative vitreoretinopathy (PVR) requires a multidim ensional approach. Recent studies have focused on pharmacologic techni ques to inhibit intraocular cell proliferation by applying antimetabol ite drugs. Side effects associated with these drugs and difficulties i n 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 propertie s for intraocular drug delivery. In this study, we evaluated the effic acy of the device with two different concentrations of 5-fluorouracil (5-FU) in an experimental model of PVR in rabbit eyes. Both devices sh owed significant (P < 0.05) efficacy in prevention of PVR. Devices con taining 20% 5-FU (total of 1 mg) were 100% effective in prevention of tractional retinal detachment. No significant complications, other tha n mild vitreous hemorrhage in a few cases, were associated with this m ethod. Because pharmacologic therapy is used as an augmenting method t o surgical therapy, these devices can be easily implanted inside the e ye through a sclerotomy at the completion of surgery without any disco mfort to patients. Slow release of drug by this method reduces the inc idence of toxicity and increases the efficacy by providing a constant concentration of drug during the active period of the disease.