A comparative study of the safety and efficacy effect of 5-fluorouracil or mitomycin C mounted biological delivery membranes in a rabbit model of glaucoma filtration surgery

Zhihong Wu,1 Shuning Li,2 Ningli Wang,2 Wanshun Liu,3 Wen Liu3 1General Hospital of Armed Police Forces, Beijing, People’s Republic of China; 2Beijing Tongren Eye Center, Capital Medical University, Beijing, People’s Republic of China 3Ocean University of China, Qingdao, People&a...

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Main Authors: Wu ZH, Li SN, Wang NL, Liu WS, Liu W
Format: Article
Language:English
Published: Dove Medical Press 2013-03-01
Series:Clinical Ophthalmology
Online Access:http://www.dovepress.com/a-comparative-study-of-the-safety-and-efficacy-effect-of-5-fluorouraci-a12606
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author Wu ZH
Li SN
Wang NL
Liu WS
Liu W
author_facet Wu ZH
Li SN
Wang NL
Liu WS
Liu W
author_sort Wu ZH
collection DOAJ
description Zhihong Wu,1 Shuning Li,2 Ningli Wang,2 Wanshun Liu,3 Wen Liu3 1General Hospital of Armed Police Forces, Beijing, People&rsquo;s Republic of China; 2Beijing Tongren Eye Center, Capital Medical University, Beijing, People&rsquo;s Republic of China 3Ocean University of China, Qingdao, People&rsquo;s Republic of China Purpose: To investigate the potential usage of biological delivery membranes containing mitomycin C (MMC) or 5-fluorouracil (5-FU) in the construction of glaucoma-filtering blebs, and to evaluate their safety and efficacy. Methods: Chitosan was selected as the biological membrane carrier to prepare sustained-released membranes. Twelve micrograms of 5-FU or MMC was covalently conjugated onto the membranes by solvent volatilization. Rabbits underwent glaucoma filtration surgery and were randomly allocated into one of the four treatment regimens: glaucoma filtration operation with no implantation of chitosan membrane group (as control), drug-free chitosan membrane implantation group (blank/placebo group), membrane containing 5-FU treatment group (5-FU group), and membrane containing MMC treatment group (MMC group). Each group consisted of 12 rabbits. Intraocular pressure (IOP) was measured and evaluated over a 28-day period follow-up preoperatively, then after surgery on days 1, 3, 5, 7, 14, 21, and 28 by Tono-Pen. The aqueous humor was analyzed in each experimental and control groups at days 4, 6, 8, 10, 12, 14, 16, and 20 after operation. Bleb survival and anterior segment were examined with a slit lamp microscope and photographed simultaneously. Two rabbits from each group were killed on day 28 and eight eye samples obtained for histopathological study. Corneas and lenses were examined by transmission and scanning electron microscopy. Results: Both 5-FU and MMC significantly prolonged bleb survival compared with control groups. The filtering bleb&rsquo;s survival period was significantly more prolonged in the MMC and 5-FU groups (maintained 14 days) than the other two groups (maintained 7 days). Significantly lower IOP was observed within the control, blank, and 5-FU groups after surgery on day 14 compared with that before operation, with F-values of 6.567, 11.426, and 13.467, respectively (P < 0.01). The most significant lower IOP was recorded in the MMC group on day 28 postoperation (F-value 26.866, P < 0.01). No obvious abnormalities were found in cornea or anterior lens capsule 28 days after surgery. Conclusion: The study provided evidence that 5-FU and MMC biological delivery membranes could significantly improve the outcome of filtering procedures, the survival of the bleb, and maintenance of lower IOP. MMC membrane is superior to 5-FU, with regard to the more effective reduction of IOP. The results indicated a safe and effective treatment strategy in glaucoma surgery. Keywords: chitosan, biological delivery, mitomycin C (MMC), 5-fluorouracil (5-FU), glaucoma
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spelling doaj.art-0ffd5f506f7146b882dd06806671a5e82022-12-21T20:07:39ZengDove Medical PressClinical Ophthalmology1177-54671177-54832013-03-012013default655662A comparative study of the safety and efficacy effect of 5-fluorouracil or mitomycin C mounted biological delivery membranes in a rabbit model of glaucoma filtration surgeryWu ZHLi SNWang NLLiu WSLiu WZhihong Wu,1 Shuning Li,2 Ningli Wang,2 Wanshun Liu,3 Wen Liu3 1General Hospital of Armed Police Forces, Beijing, People&rsquo;s Republic of China; 2Beijing Tongren Eye Center, Capital Medical University, Beijing, People&rsquo;s Republic of China 3Ocean University of China, Qingdao, People&rsquo;s Republic of China Purpose: To investigate the potential usage of biological delivery membranes containing mitomycin C (MMC) or 5-fluorouracil (5-FU) in the construction of glaucoma-filtering blebs, and to evaluate their safety and efficacy. Methods: Chitosan was selected as the biological membrane carrier to prepare sustained-released membranes. Twelve micrograms of 5-FU or MMC was covalently conjugated onto the membranes by solvent volatilization. Rabbits underwent glaucoma filtration surgery and were randomly allocated into one of the four treatment regimens: glaucoma filtration operation with no implantation of chitosan membrane group (as control), drug-free chitosan membrane implantation group (blank/placebo group), membrane containing 5-FU treatment group (5-FU group), and membrane containing MMC treatment group (MMC group). Each group consisted of 12 rabbits. Intraocular pressure (IOP) was measured and evaluated over a 28-day period follow-up preoperatively, then after surgery on days 1, 3, 5, 7, 14, 21, and 28 by Tono-Pen. The aqueous humor was analyzed in each experimental and control groups at days 4, 6, 8, 10, 12, 14, 16, and 20 after operation. Bleb survival and anterior segment were examined with a slit lamp microscope and photographed simultaneously. Two rabbits from each group were killed on day 28 and eight eye samples obtained for histopathological study. Corneas and lenses were examined by transmission and scanning electron microscopy. Results: Both 5-FU and MMC significantly prolonged bleb survival compared with control groups. The filtering bleb&rsquo;s survival period was significantly more prolonged in the MMC and 5-FU groups (maintained 14 days) than the other two groups (maintained 7 days). Significantly lower IOP was observed within the control, blank, and 5-FU groups after surgery on day 14 compared with that before operation, with F-values of 6.567, 11.426, and 13.467, respectively (P < 0.01). The most significant lower IOP was recorded in the MMC group on day 28 postoperation (F-value 26.866, P < 0.01). No obvious abnormalities were found in cornea or anterior lens capsule 28 days after surgery. Conclusion: The study provided evidence that 5-FU and MMC biological delivery membranes could significantly improve the outcome of filtering procedures, the survival of the bleb, and maintenance of lower IOP. MMC membrane is superior to 5-FU, with regard to the more effective reduction of IOP. The results indicated a safe and effective treatment strategy in glaucoma surgery. Keywords: chitosan, biological delivery, mitomycin C (MMC), 5-fluorouracil (5-FU), glaucomahttp://www.dovepress.com/a-comparative-study-of-the-safety-and-efficacy-effect-of-5-fluorouraci-a12606
spellingShingle Wu ZH
Li SN
Wang NL
Liu WS
Liu W
A comparative study of the safety and efficacy effect of 5-fluorouracil or mitomycin C mounted biological delivery membranes in a rabbit model of glaucoma filtration surgery
Clinical Ophthalmology
title A comparative study of the safety and efficacy effect of 5-fluorouracil or mitomycin C mounted biological delivery membranes in a rabbit model of glaucoma filtration surgery
title_full A comparative study of the safety and efficacy effect of 5-fluorouracil or mitomycin C mounted biological delivery membranes in a rabbit model of glaucoma filtration surgery
title_fullStr A comparative study of the safety and efficacy effect of 5-fluorouracil or mitomycin C mounted biological delivery membranes in a rabbit model of glaucoma filtration surgery
title_full_unstemmed A comparative study of the safety and efficacy effect of 5-fluorouracil or mitomycin C mounted biological delivery membranes in a rabbit model of glaucoma filtration surgery
title_short A comparative study of the safety and efficacy effect of 5-fluorouracil or mitomycin C mounted biological delivery membranes in a rabbit model of glaucoma filtration surgery
title_sort comparative study of the safety and efficacy effect of 5 fluorouracil or mitomycin c mounted biological delivery membranes in a rabbit model of glaucoma filtration surgery
url http://www.dovepress.com/a-comparative-study-of-the-safety-and-efficacy-effect-of-5-fluorouraci-a12606
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