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Suzanne Einmahl, Francine Behar–Cohen, François D’Hermies, Serge Rudaz, Cyrus Tabatabay, Gilles Renard, Robert Gurny; A New Poly(Ortho Ester)-Based Drug Delivery System as an Adjunct Treatment in Filtering Surgery. Invest. Ophthalmol. Vis. Sci. 2001;42(3):695-700.
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purpose. Pharmacologic modulation of wound healing after glaucoma filtering surgery remains a
major clinical challenge in ophthalmology. Poly(ortho ester) (POE) is a
bioerodible and biocompatible viscous polymer potentially useful as a
sustained drug delivery system that allows the frequency of intraocular
injections to be reduced. The purpose of this study was to determine
the efficacy of POE containing a precise amount of 5-fluorouracil
(5-FU) in an experimental model of filtering surgery in the rabbit.
methods. Trabeculectomy was performed in pigmented rabbit eyes. An ointmentlike
formulation of POE containing 1% wt/wt 5-FU was injected
subconjunctivally at the site of surgery, during the procedure.
Intraocular pressure (IOP), bleb persistence, and ocular inflammatory
reaction were monitored until postoperative day 30. Quantitative
analysis of 5-FU was performed in the anterior chamber. Histologic
analysis was used to assess the appearance of the filtering fistula and
the polymer’s biocompatibility.
results. The decrease in IOP from baseline and the persistence of the filtering
bleb were significantly more marked in the 5-FU–treated eyes during
postoperative days 9 through 28. Corneal toxicity triggered by 5-FU was
significantly lower in the group that received 5-FU in POE compared
with a 5-FU tamponade. Histopathologic evaluation showed that POE was
well tolerated, and no fibrosis occurred in eyes treated with POE
conclusions. In this rabbit model of trabeculectomy, the formulation based on POE
and containing a precise amount of 5-FU reduced IOP and prolonged bleb
persistence in a way similar to the conventional method of a 5-FU
tamponade, while significantly reducing 5-FU
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