[Prevention of proliferative vitreoretinopathy using 5-FU heparin: clinical tolerance and efficacy].
OBJECTIVE
To study the safety and efficacy of adjuvant combination therapy using 5-fluorouracil and heparin for prevention of proliferative vitreoretinopathy (PVR) during vitrectomy for retinal detachment surgery.


METHODS
Two consecutive groups of 30 eyes with a rhegmatogenous retinal detachment (grade C1 or more) were prospectively compared. In the study group, 5-FU and heparin were administrated in the intraoperative infusion. Clinical safety and the efficacy were regularly studied over 1 year.


RESULTS
In the 5-FU heparin therapy group, keratitis was more frequently observed the 1st day after surgery (p = 0.005), but not after 1 week (p = 0.54). However, conjunctival hyperemia was more severe after 1 and 7 days (p = 0.04). In both groups, no differences were found concerning intraocular pressure, postoperative hemorrhage or inflammatory reaction (flare) of the anterior chamber and the aspect of the eyelids (p > or = 0.14). The number of reoperations resulting from PVR, after 1 month and 1 year, was not significantly different between the two groups (p > or = 0.3). The reattachment rate and visual acuity (BSCVA) were not statistically different after 1 year (p > or = 0.12).


CONCLUSIONS
Adjuvant combination therapy using 5-FU and heparin seems to be safe. However, its efficacy needs to be demonstrated by larger studies including eyes presenting a lower grade of PVR (grade B).
Scheer
S
S
Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris cedex 12. scheer@quinze-vingts.fr
Morel
C
C
Poisson
F
F
Bonnel
S
S
Touzeau
O
O
Sahel
J-A
JA
Laroche
L
L
D004359:Drug Therapy, Combination; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014821:Vitrectomy / Q000009:adverse effects; D018630:Vitreoretinopathy, Proliferative / Q000209:etiology / Q000517:prevention & control*
D006493:Heparin; D005472:Fluorouracil