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Yangfan Yang, Xianchai Lin, Kaili Wu, Minbin Yu; Evaluation of Pirfenidone as a Postoperative Anti-proliferative Agent in Experimental Cataract Surgery: A Pilot Study. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6308. doi: https://doi.org/.
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Posterior capsular opacification (PCO) is a common complication of cataract surgery. The existing pharmacological treatments are not satisfactory and can have toxic side effects. Pirfenidone inhibits TGF-b2-induced proliferation, migration and epithlial-mesenchymal transition of human lens epithelial cells at nontoxic concentrations in vitro. The present study was to investigate the in vivo effects of topical administration of pirfenidone on PCO in a rabbit model of experimental cataract surgery.
In a randomized, controlled, masked-observer study, 10 rabbits underwent phacoemulsification in the right eyes and randomly received postoperative administration of 0.5% pirfenidone or no treated. Posterior capsular transparency were evaluated over a period of 8 weeks. We compared the PCO appearance time, range and degree, and the area of PCO on days 7, 14, 28 and 56 between pirfenidone group and control group. The animals were killed on days 56. Histopathology were performed to determine the amount of PCO. Ocular toxicity was assessed by the Draize test and histopathology.
In the two treatment groups, there is no difference with conjunctival hyperemia, corneal edema and opacity of aqueous. Pirfenidone 0.5% significantly delayed PCO occurence. and the area of PCO in posterior capsule of pirfenidone group is much lesser than control group. Furthermore, the histology results showed that the 0.5% pirfenidone groups had less PCO at days 56 than did the controls. Toxicity assessments didn't showed that pirfenidone damage the rabbit eyes.
Postoperative use of 0.5% pirfenidone eye drops delayed the PCO occurrence in a rabbit model. Pirfenidone eye drops may be a safe and effective anti-proliferative agent in cataract surgery.
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