[The inhibitory effect of tissue plasminogen activator combined with 5-fluorouracil polyphase liposome on the scar formation in experimental filtration surgery].
OBJECTIVE
To study the effect of tissue plasminogen activator (t-PA) in combination with 5-fluorouracil (5-Fu) polyphase liposome on the prevention of scar formation in filtration surgery.


METHODS
Bilateral trabeculectomy filtering procedures were performed on 16 New Zealand white rabbits. The rabbits were divided into 4 groups of four rabbits each. In a randomized fashion, the first group received intracameral normal saline (0.1 ml) immediately following surgery and subconjunctival injection of 0.2 ml polyphase liposome (no drug) every 4 days serving as the control. The second group received intracameral t-PA 25 micrograms (0.1 ml) immediately following surgery. The third group received subconjunctival 5-Fu polyphase liposome 5 mg immediately after the procedures of filtration surgery and then every four days for another three injections. The fourth group received both intracameral t-PA 25 micrograms and subconjunctival 5-Fu polyphase liposome as in the third group. All eyes of the four groups were enucleated two weeks after the operation.


RESULTS
Two weeks after the surgery, the average intraocular pressure demonstrated a significant decrease in the third and fourth groups (P < 0.05), but did not show a significant decrease (P > 0.05) in the control and the second groups, as compared with the average preoperative intraocular pressure correspondingly. Morphometric analysis of the area of fibrosis from histopathological sections demonstrated a significant decrease of episcleral fibrosis in the three drug-treated groups as compared with the control group. Moreover, the area of fibrosis in the fourth group was the least among the three drug-treated groups. Analysis of variance of 2 x 2 factorial design showed that t-PA and 5-Fu polyphase liposome had synergetic effect on the inhibition in all of the drug-treated eyes.


CONCLUSIONS
Postoperatively, the inhibitory effect of intracameral t-PA combined with subconjunctival 5-Fu polyphase liposome on the scar formation in filtration surgery is more prominent than that of t-PA or 5-Fu used alone. They had synergetic effect on the inhibition of scar formation in filtration surgery.
Jing
M
M
Department of Ophthalmology, No. 411 Navy Hospital, Shanghai.
Xi
S
S
Chen
R
R
D000818:Animals; D002921:Cicatrix / Q000517:prevention & control*; D004337:Drug Carriers; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D005355:Fibrosis; D005472:Fluorouracil / Q000008:administration & dosage*; D005901:Glaucoma / Q000601:surgery*; D008081:Liposomes; D008297:Male; D011817:Rabbits; D011897:Random Allocation; D012590:Sclera / Q000473:pathology; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D014130:Trabeculectomy / Q000009:adverse effects*
D004337:Drug Carriers; D008081:Liposomes; D010959:Tissue Plasminogen Activator; D005472:Fluorouracil