Use of perfluorocarbon liquids, silicone oil, and 5-fluorouracil in the management of experimental PVR.
OBJECTIVE
To evaluate the toxicity and efficacy of 5-fluorouracil (5-FU) in combination with perfluoroperhydrophenanthrene (Vitreon), silicone oil, or a combination of silicone oil and Vitreon in a ratio of 3:2 in the management of experimental proliferative vitreoretinopathy (PVR).


METHODS
Toxicity study. Seventy rabbit eyes underwent vitrectomy followed by intravitreal injection of 5-FU in doses of 800, 400, or 200 microg: Group 1, 5-FU alone; Group 2, 5-FU plus 1 mL Vitreon; Group 3, 5-FU plus 1 mL silicone oil; Group 4, 5-FU plus 0.6 mL silicone oil and 0.4 mL Vitreon; Group 5, 0.6 mL silicone oil plus 0.4 mL Vitreon. Electroretinography was performed preoperatively and 8 weeks postoperatively before the animals were sacrificed. Efficacy study. Seventy-two rabbit eyes underwent vitrectomy and were injected intravitreally with 100,000-200,000 retinal pigment epithelial cells to induce PVR. Groups were injected with 200 microg 5-FU alone or with 1 mL silicone oil, 1 mL Vitreon, or a combination of 0.6 mL silicone oil and 0.4 mL Vitreon. Others were given only 1 mL Vitreon or 1 mL silicone oil. The animals were followed for 8-12 weeks; PVR was graded using Fastenberg's system.


RESULTS
Toxicity study. Eyes given 200 microg 5-FU, silicone, and Vitreon showed mild inflammation and vitritis which resolved in 1 week; the dose was nontoxic by electroretinography and histopathology. Doses of 400 and 800 microg 5-FU were toxic. Efficacy study. Clinical severity of PVR was less in the groups which received 5-FU plus vitreous substitutes when compared to the control groups at all time points. The lowest incidences were in groups given 5-FU plus Vitreon or 5-FU plus Vitreon and silicone oil: 33.33% and 11.11%, respectively.


CONCLUSIONS
A dose of 200 microg 5-FU with silicone oil and Vitreon combined was nontoxic to the rabbit retina. The combination of 5-FU, Vitreon, and silicone oil showed significant efficacy in the prevention of experimental PVR.
Hegazy
H M
HM
LSU Eye Center, Louisiana State University Medical Center School of Medicine, New Orleans, 70112-2234, USA.
Peyman
G A
GA
Liang
C
C
Unal
M H
MH
Molinari
L C
LC
Kazi
A A
AA
D000818:Animals; D004195:Disease Models, Animal; D004359:Drug Therapy, Combination; D004596:Electroretinography; D005466:Fluorocarbons / Q000627:therapeutic use* / Q000633:toxicity; D005472:Fluorouracil / Q000627:therapeutic use* / Q000633:toxicity; D007267:Injections; D011817:Rabbits; D012160:Retina / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D012827:Silicone Oils / Q000627:therapeutic use* / Q000633:toxicity; D016896:Treatment Outcome; D014821:Vitrectomy; D018630:Vitreoretinopathy, Proliferative / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D014822:Vitreous Body
D005466:Fluorocarbons; D012827:Silicone Oils; D005472:Fluorouracil; C047722:perfluorophenanthrene