Effect of slow-releasing all-trans-retinoic acid in bioabsorbable polymer on delayed adjustable strabismus surgery in a rabbit model.
OBJECTIVE
To determine the usefulness of slow-releasing all-trans-retinoic acid (ATRA) in polytetrafluoroethylene (PTFE)/polylactide-co-glycolide (PLGA) for delayed adjustable strabismus surgery.


METHODS
Animal study.


METHODS
A prospective, masked-observer, controlled study was performed in 25 rabbits. Fifty rabbit eyes were divided randomly into three groups. After a recession of the superior rectus muscle, a PTFE/PLGA laminate containing ATRA, PTFE alone, or balanced salt solution was applied beneath and over the superior rectus muscle in the PTFE/PLGA/all-trans-retinoic acid group (ATRA group), the polytetrafluoroethylene group (PTFE group), and the control group, respectively. Delayed adjustment was performed once on each superior rectus muscle at 3 or 5 weeks after surgery by a masked observer.


RESULTS
In the control group, adjustment was possible in 2 of 5 eyes at 3 weeks after surgery and impossible in any eye at 5 weeks after surgery. In the PTFE and ATRA groups, adjustment was possible in all 10 eyes at 3 and 5 weeks after surgery. On comparing adjustability, a significant difference was observed between the PTFE group and the control group or between the ATRA group and the control group 5 weeks after surgery (P = .0003 and P = .0003, respectively). A significant difference was observed between the ATRA group and the control group in terms of adhesion between superior rectus muscles and sclerae at 5 weeks after surgery (P = .006).


CONCLUSIONS
Slow-releasing ATRA in PTFE/PLGA was found to reduce adhesion and to allow delayed adjustment in most eyes for up to 5 weeks after surgery.
Lee
Min Joung
MJ
Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
Jin
Su-Eon
SE
Kim
Chong-Kook
CK
Choung
Ho-Kyung
HK
Kim
Hwa Jung
HJ
Hwang
Jeong-Min
JM
D020341:Absorbable Implants; D000818:Animals; D003692:Delayed-Action Preparations; D016503:Drug Delivery Systems; D005355:Fibrosis / Q000517:prevention & control; D007641:Keratolytic Agents / Q000008:administration & dosage*; D019344:Lactic Acid; D009801:Oculomotor Muscles / Q000187:drug effects / Q000473:pathology / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D011100:Polyglycolic Acid; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011138:Polytetrafluoroethylene; D011446:Prospective Studies; D011817:Rabbits; D013285:Strabismus / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D013536:Suture Techniques; D014212:Tretinoin / Q000008:administration & dosage*
D003692:Delayed-Action Preparations; D007641:Keratolytic Agents; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011100:Polyglycolic Acid; D019344:Lactic Acid; D014212:Tretinoin; D011138:Polytetrafluoroethylene