title: A novel antiproliferative drug coating for glaucoma drainage devices.
abstract: OBJECTIVE
  The implantation of a glaucoma drainage device (GDD) is often necessary for intractable cases of glaucoma. Currently, the success rate of GDD implants is relatively low because fibrosis that develops during the wound-healing process ultimately blocks fluid drainage. We describe herein a novel porous coating for Ahmed glaucoma valves based on biodegradable poly(lactic-co-glycolic acid) (PLGA).
  
  
  METHODS
  Thin films of PLGA were fabricated using a spin-coating technique. The procedure led to an asymmetric pore structure that was exploited to control the rate of dissolution. Double-layered porous films were constructed to achieve continuous drug release. A cell culture system was used to test the efficacy of these coatings.
  
  
  RESULTS
  Double-layered films were manufactured to provide a burst of mitomycin C (MMC) release followed by a slow release of 5-fluorouracil (5-FU), which together prevented fibrosis over the most active period of postoperative wound healing (0 to 28 d). Double-layered films containing 5-FU only in the bottom layer showed a 3- to 5-day delay in drug release, followed by a sharp increase that continued for ~28 days. MMC was stable only when surface-loaded, and this drug was therefore surface-loaded onto the top PLGA layer to provide a continuous release of antifibrotics over the wound-healing period.
  
  
  CONCLUSIONS
  The combined use of both MMC and 5-FU in a biodegradable device inhibits cell proliferation in a tissue culture model and has the potential to reduce fibrosis and increase the success rate of GDD implants. The design is simple and can be scaled for commercial production.
authors: Departments of †Biochemistry and Molecular Biology ‡Ophthalmology, Tulane University School of Medicine *Chemical and Biomolecular Engineering, Tulane University, New Orleans, LA.
authors: Thiruselvam
authors: T
authors: Ponnusamy
authors: Haini
authors: H
authors: Yu
authors: Vijay T
authors: VT
authors: John
authors: Ramesh S
authors: RS
authors: Ayyala
authors: Diane A
authors: DA
authors: Blake
mesh_terms: D020341:Absorbable Implants; D000818:Animals; D019556:COS Cells; D002522:Chlorocebus aethiops; D016503:Drug Delivery Systems; D005355:Fibrosis / Q000209:etiology / Q000517:prevention & control; D005472:Fluorouracil / Q000008:administration & dosage* / Q000737:chemistry; D005901:Glaucoma / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D019344:Lactic Acid / Q000737:chemistry*; D016685:Mitomycin / Q000008:administration & dosage* / Q000737:chemistry; D011100:Polyglycolic Acid / Q000737:chemistry*; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer
chemical_list: D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011100:Polyglycolic Acid; D019344:Lactic Acid; D016685:Mitomycin; D005472:Fluorouracil