Intracapsular ring sustained 5-fluorouracil delivery system for the prevention of posterior capsule opacification in rabbits: a histological study.
OBJECTIVE
To evaluate the efficacy of an intracapsular ring releasing 5-fluorouracil (5-FU) in preventing posterior capsule opacification (PCO) in rabbit eyes.


METHODS
Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA, and Chu Morvan, Department d'Ophtalmologie, University of Brest, France.


METHODS
Seventeen rabbits were divided into 3 groups: Group 1, 6 rabbits (6 eyes), had phacoemulsification only (control group); Group 2, 6 rabbits (6 eyes), had phacoemulsification with implantation of an open-loop hydrogel intracapsular ring; Group 3, 5 rabbits (5 eyes), had phacoemulsification with implantation of a ring with sustained release of 0.25 microg/h of 5-FU for 9 days. All eyes were followed for 8 weeks before enucleation. Capsular bag shrinkage and the position of the intracapsular ring were assessed, and central and peripheral PCO was evaluated for intensity and area by stereomicroscopy from a posterior (Miyake-Apple) view. The residual equatorial lens epithelial cells (LECs) were counted by the same observer in histological sections. Transmission electron microscopy (TEM) of the cornea, capsular bag, and retina was done to evaluate the toxicity of 5-FU.


RESULTS
No significant difference was seen in the degree of capsular bag shrinkage in the 3 groups. The intracapsular ring was decentered in 2 eyes (1 each in Groups 2 and 3). There was a statistically significant difference (P <.05, Student t test) between Group 1 and Groups 2 and 3 in the area and intensity of central PCO. There was no difference between Groups 2 and 3 in the intensity of central PCO. No evidence of 5-FU toxicity to intraocular structures (cornea, capsular bag, and retina) was demonstrated on TEM analysis.


CONCLUSIONS
Implantation of an intracapsular ring may prevent central PCO after cataract surgery by mechanically blocking LEC migration toward the central visual axis. The potential pharmacological effect of 5-FU in PCO prevention was not demonstrated.
Pandey
Suresh K
SK
Center for Research on Ocular Therapeutics and Biodevices, Medical University of South Carolina, 167 Ashley Avenue, Charleston, SC 29425, USA.
Cochener
Béatrice
B
Apple
David J
DJ
Colin
Joseph
J
Werner
Liliana
L
Bougaran
Rémi
R
Trivedi
Rupal H
RH
Macky
Tamer A
TA
Izak
Andrea M
AM
D000818:Animals; D000963:Antimetabolites / Q000008:administration & dosage*; D002386:Cataract / Q000473:pathology / Q000517:prevention & control*; D003315:Cornea / Q000187:drug effects / Q000473:pathology; D016503:Drug Delivery Systems; D004343:Drug Implants; D004847:Epithelial Cells / Q000187:drug effects / Q000473:pathology; D005472:Fluorouracil / Q000008:administration & dosage*; D007903:Lens Capsule, Crystalline / Q000187:drug effects* / Q000473:pathology; D018918:Phacoemulsification; D011183:Postoperative Complications / Q000473:pathology / Q000517:prevention & control*; D011817:Rabbits; D012160:Retina / Q000187:drug effects / Q000473:pathology
D000963:Antimetabolites; D004343:Drug Implants; D005472:Fluorouracil