Prevention of posterior capsule opacification by intraoperative single-dose pharmacologic agents

Purpose. To determine whether an intraoperative single dose of dexamethason e, diclofenac, ethylenediaminetetraacetic acid (EDTA), a combination of EDT A and RGD peptide (arginine-glycin-aspartic acid sequence), or mitomycin-C (MMC) is a pharmacological means of preventing or reducing the development of posterior capsule opacification (PCO). Setting. Department of Ophthalmology, Celal Bayar University, School of Med icine, Manisa, and Department of Pathology, Dokur Eylul University, School of Medicine, izmir, Turkey. Methods: Fifty-four rabbits were randomly divided into 6 groups. Dexamethas one (4 mg/cc), diclofenac (2.5 mg/cc), EDTA (8 mg/cc), a combination of EDT A and RGD peptide (2.5 mg/cc), or MMC (0.04 mg/cc) was given, 0.1 cc by hyd rodissection and 0.9 cc into the capsular bag after phacoemulsification. Th e sixth group served as a control group. After 3 months, the PCO was graded clinically and the proliferation of lens epithelial cells (LECs) was evalu ated histologically. Results: The drugs were significantly effective in preventing PCO compared with the control (P < .005). Dexamethasone had a weaker effect than the oth er drugs. In histological analysis, although monolayer LECs in the dexameth asone and diclofenac groups were observed, there was no proliferative activ ity on the posterior capsules in the EDTA, EDTA+RGD, and MMC groups in cont rast to the multilayer cells in the control. Conclusions: Intraoperative single-dose application of EDTA, EDTA+RGD pepti de combination, and MMC significantly prevented the development of PCO in r abbit eyes. Diclofenac was less effective but also reduced PCO. Although de xamethasone did not prevent the proliferation of LECs, it decreased PCO cli nically. (C) 2001 ASCRS and ESCRS.