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P Mruthyunjaya, W Tseng, S Stinnett, P Ashton, GJ Jaffe; Fluocinolone Acetonide Sustained Drug Delivery System in the Treatment of Experimental Proliferative Vitreoretinopathy . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3003.
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Purpose: Proliferative vitreoretinopathy (PVR) is the leading cause of failure of retinal reattachment surgery. Several pharmacologic agents have been used clinically and experimentally in attempts to prevent PVR formation. The purpose of this study is to assess the ability of a fluocinolone acetonide (FA) sustained drug delivery system to inhibit 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 26 NZW rabbits. In this model, PVR typically develops over an 8-12 week period. A 6 mg FA pellet was compressed, coated with PVA/silicone laminate, heat treated, then affixed to a PVA suture strut to create a sustained delivery device that releases FA at approximately 6 ug/day. The device was implanted in 13 eyes at the time PVR was first induced. In the remaining animals (control), only a PVA strut was inserted and secured. The severity of PVR in the two groups was graded by indirect ophthalmoscopy in a masked fashion by 2 observers at weekly intervals over 12 weeks. Results: The severity of PVR was significantly lower in the FA implant group compared to controls from weeks 8 through 12 (p<0.05). The number of eyes with moderate retinal detachments was also lower in the FA group. Conclusions: The FA sustained release device reduces the rate of PVR in an experimental model. The beneficial effect of this drug system is seen at time points that approximate the development of PVR in humans. This FA delivery device may be a suitable adjuvant treatment option for the vitreoretinal surgeon to prevent PVR after retinal reattachment surgery.
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