Tavşanlarda glakom filtrasyon operasyonu üzerine 5-fluorourasil ve mitomycin-C' nin etkileri

The purpose of this study was to examine the effects of 5-fluorouracil (5-FU) and mytomycine-C (MMC) on the success rate of glaucoma filtration surgery (GFS). A superior fornix-based conjunctival flap was created on the right eyes of 12 rabbits divided randomly into three equal groups termed groups 1, 2 and 3. After a small piece of sponge soaked with balanced salt solution (BSS) in group 1 (control), 5-FU (50 mg/ ml) in group 2 and MMC (0.02 mg/ ml) in group 3 was kept on the filtration sites for 5 minutes, the filtration fistula (sclerectomy) was performed and the flap was replaced. Postoperatively, BSS, 5-FU and MMC with doses of 0.1 ml were injected 4 times with certain intervals into the inferior fornixes of the same groups. The presence of the corneal edema, neovascularization and defect, appearance of the filtering bleb, states of the aqueous humor, iris, lens and changes in intraocular pressure (IOP) were observed. In one case, severe conjunctival hyperemia associated with the corneal flush and hyphema was determined. A mild corneal edema in half the members of group 1, and all the members of groups 2 and 3, was found. The IOP, which reduced sharply in all cases immediately after the GFS, reached its preoperative level approximately in 14, 28 and 51 days in groups 1, 2 and 3, respectively. There was a significant difference (P

Effects of 5- fluorouracil and mitomycine-C on glaucoma filtration surgery in rabbits

PDF

___

1. Serle, J.B.: Pharmacological advances in the treatment of glaucoma. Drugs Aging 1994; 5, (3): 156-170.
2. Renwick, P.W.: Glaucoma. Manual of small animal ophthalmology (Eds, Jones SMP. and Crispin SM) BSAVA, Sussex. 193-211, 1993.
3. Akın, F. and Samsar, E.: Göz Hastalıkları, Tamer Matbacılık. Ankara. 113-117, 1999.
4. Tilleul, P., Denis, P., Maignen, F., Elena, P.P., Nordmann, J.P., Leverge, R. and Rostene, W.: Effect of different formulation of mitoxantrone (solutions, nanospheres, liposomes) on glaucoma surgery in rabbits. Ophthalmic Res. 1997; 19, (4): 218-226.
5. Sakamoto, T., Oshima, Y., Sakamoto, M., Kawano, Y.I., Ishibashi, T., Inomata, H. and Ohnishi, Y.: Electroporation and bleomycine in glaucoma-filtering surgery. Invest. Ophthalmol. Vis. Sci. 1997, 38, (13): 2864-2868.
6. Doyle, J.W., Sherwood, M.B., Khaw, P.T., McGrory, S. and Smith MF.: Intraoperative 5-fluorouracil for filtration surgery in the rabbit. Invest. Ophthalmol. Vis. Sci. 1993; 34, (12): 3313-3319.
7. Roth, S..M., Spaeth, G.L., Starita, R.J., Birbillis, E.M. and Steinmann, W.C.: Effects of postoperative corticosteroids on trabeculectomy and the clinical course of glaucoma. The five-year follow up study. Ophthalmic Surg. 1991; 22: 724-729.
8. Weinreb, R.N.: Adjusting the dose of 5-fluorouracil after filtration surgery to minimize side effects. Ophthalmology. 1987; 94: 564- 670.
9. Finkelstein, I., Trope, G.E., Heathcote, J.G., Rootman, D.S., Spero, L. and Manon, I.A.: Further evaluation of collagen shields as a delivery system for 5-fluorouracil in glaucoma filtration surgery: Can. J. Ophthalmol. 1991; 26: 129-132.
10. Charles, J.B., Ganthier, R.J. and Wilson, M.R.: Use of bioerodible polymers impregnated with mytomycine in glaucoma filtration surgery in rabbits. Ophthalmology. 1991; 98: 503-508.
11. Khaw, P.T., Doyle, J.W., Sherwood, M.B., Grierson, I., Schultz, G. and McGorray, S.: Prolonged localized tissue effects from 5- minute exposures to fluorouracil and mytomycine C. Arch. Ophthalmol. 1993; 111, (2): 263-267.
12. Jampel, H.D., Thibault, D., Leong, K.M., Uppal, P. and Quingley, H..A.: Glaucoma Filtration surgery in nonhuman primates using taxol and etoposide in polyanhydride carriers. Invest. Ophthalmol. Vis. Sci. 1993; 34, (11): 3076-3083.
13. Stainhorst, U.H., Chen, E.P., Freedman, S.F., Machemer, R., and Hatchell, D.L.: Growth inhibition of human Tenon’s capsule fibroblasts and rabbit dermal fibroblasts with non-carcinogenic Nalkylated anthracyclines. Graefes Arch. Clin. Exp. Ophthalmol. 1994; 232, (6): 347-354.
14. Kitazawa, Y., Kawase, K., Matsushita, H. and Minobe, M.: Trabeculectomy with mytomicine. A comparative study with fluorouracil. Arch. Ophthalmol. 1991; 109: 1693-1698.
15. Kitazawa, Y., Taniguchi, T., Nakano, Y., Shirato, S. and Yamamato, S.: 5-Fluorouracil for trabeculectomy in glaucoma. Graefes Arch. Clin. Exp. Ophthalmol. 1987; 225: 403-405.
16. Buffenn, A.N., Seatre, S.B., Higginbotham, E.J., Musch, D.C. and Kincaid, M.C.: Transconjunctival mytomycine-C as an adjunct to conventional glaucoma. J. Glaucoma. 1997; 6, (5): 314-318.
17. Iliev, M.E., Zypen, E., Frankhauser, F. and England, C.: Transconjuctival application of mytomycine-C in combination with laser sclerotomy ab interno: A long-term morphological study of the postoperative healing process. Exp. Eye Res. 1997; 64, (6): 1031-1026.
18. Hyung, S.M., Kim, D.M., Hong, C., Lee, J. and Young, D.H.: Effects of postoperative mytomycine-C on glaucoma filtration surgery in rabbits treated preoperatively with antiglaucoma medications. Ophthalmic Surg. 1994; 25, (10): 704-714.
19. Bair, J.S. and Chen, C.W.: Trabeculectomy with multible application of mytomycine-C in monkeys with experimental glaucoma. J. Pharmacol. Ther. 1997; 13, (2): 115-128.
20. Prata, J.A.J., Seah, S.K.L., Minckler, D.S., Baerveldt, G., Lee, P.P., and Heuer, D.K.: Postoperative complications and short-term outcome after 5-fluorouracil or mytomycine-C trabeculectomy. J. Glaucoma 1995; 4: 25-31.
21. Glover, T.L., Nasisse, M.P. and Davidson, M.G.: Effects of topically applied mytomycine-C on intraocular pressure, facility of outflow, and fibrosis after glaucoma filtration surgery in clinically normal dogs. Am. J. Vet. Res. 1995; 56, (7): 936-940.
22. Mietz, H., Niesen, U. and Krieglstein, G.K.: The effect of preservatives and antiglaucomatous medications on the histopathology of the conjunctiva. Greafes Arch. Clin. Exp. Ophthalmol. 1994; 232, (9): 561-565.
23. Gressel, M.G., Parrish, R.K. and Folberg, R.: 5-Fluorouracil and glaucoma filtering surgery: I. An animal model. Ophthalmology. 1984; 91: 378-383.
24. Miller, M.H., Grierson, I., Unger, W.I. and Hitchings, R.A.: Wound healing in an animal model of glaucoma fistulizing surgery in the rabbit. Ophthalmology Surg. 1989; 10: 350-357.
25. Yamamoto, T., Varani, J., Kaz Soong, H and Lichter P.R.: Effect of 5-fluorouracil and mytomycin-C on cultured rabbit subconjunctival fibroblasts. Ophthalmology. 1990; 97: 1204-1210.
26. Gilger, B.C., Whitley, D., McLaughlin, S.A., Wright, J.C. and Drane, W.: Canine corneal thickness measured by ultrasonic pachymetry. Am. J. Vet. Res. 1991; 52, (10): 1570-1572.