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D. Khalatbari, P. Mruthyunjaya, P. Yang, S. Stinnett, J. Chen, P. Ashton, G.J. Jaffe; Fluocinolone Acetonide Formulated with Sodium Hyaluronate as a Sustained Release Drug Delivery Pellet in the Treatment of Experimental Proliferative Vitreoretinopathy . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3009.
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Purpose: Proliferative vitreoretinopathy (PVR) is the leading cause of failure of retinal reattachment surgery. Several pharmacological agents and drug delivery methods have been used clinically and experimentally in attempts to prevent PVR formation. In this study we determined whether fluocinolone acetonide (FA) formulated with sodium hyaluronate as a drug delivery pellet effectively inhibits PVR in a rabbit model. Methods: To induce PVR, lensectomy and vitrectomy were performed, and full thickness retinal breaks were created by endodiathermy in the right eye of 28 New Zealand White rabbits. One milligram of FA was compressed with crystalline sodium hyaluronate into a pellet. The pellet was inserted into the vitreous cavity of 12 animals at the time of PVR induction. In the remaining animals (controls), a pellet composed of sodium hyaluronate alone was inserted into the vitreous cavity. The severity of PVR was graded weekly, from weeks 4 to 12 after PVR induction, by two masked observers using indirect ophthalmoscopy. The FA release profile of the pellet was obtained by placing the pellet in buffer, removing daily aliquots, and assaying for FA with high-pressure liquid chromatography. Results: The severity of PVR was significantly lower in treated eyes compared to controls from weeks 5 to 6 (P <= 0.035) and weeks 9 to 12 (P <= 0.022). The number of eyes with moderate to severe retinal detachments was also lower in the treated group. The pellet showed a FA release rate of 200 ug/day for the first 48 hours followed by a continuously decreasing rate with near total release by 10 to 12 days. Conclusions: Fluocinolone acetonide formulated with sodium hyaluronate as a drug delivery pellet significantly reduces the rate of PVR in an experimental model. This FA delivery method may be a useful therapeutic option for the prevention of PVR following retinal reattachment surgery.
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