Slow release of the antimetabolite 5-fluorouracil (5-FU) from modified Baerveldt glaucoma drains to prolong drain function

Jacob, Jean T.; LaCour, Owen J; Burgoyne, Claude F.

doi:10.1016/s0142-9612(01)00170-3

Cited by 32 publications

(22 citation statements)

References 23 publications

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“…2 However, rabbits did not show definitive hypertensive phase for postoperative 8 weeks, corresponding to results of previous studies using a Baerveldt glaucoma drainage device. 22,23 In the current study, IOP increased modestly from postoperative 4 to 8 weeks, but which was within normal range. One of the reasons might be that we did not induce a glaucoma model in rabbits before implantation of glaucoma drainage device.…”

Section: Discussionsupporting

confidence: 48%

“…They found that the fibrous capsule thickness was thinner, and the amount of type III collagen was less in the modified implants with porous cellular ingrowth material to the drainage plate or 5-fluorouracil treatment. 22,23 However, they did not observe proliferation of fibroblasts or the degree of conversion of fibroblasts to myofibroblasts. In our study, we investigated those factors associated with fibroblast activities, and observed FBGCs in detail.…”

Section: Discussionmentioning

confidence: 91%

“…The rabbit has been shown to be an aggressive wound healing response, such that glaucoma filtration surgeries in rabbits fail within 2 to 3 weeks postoperatively in rabbits due to aggressive wound healing at the surgical site. 20,21 Regarding glaucoma drainage device implantation, Jacob et al 22,23 documented that rabbits developed fibrous encapsulation and maintained functioning blebs for more than 3 to 6 weeks after Baerveldt drainage device implantation. They found that the fibrous capsule thickness was thinner, and the amount of type III collagen was less in the modified implants with porous cellular ingrowth material to the drainage plate or 5-fluorouracil treatment.…”

Section: Discussionmentioning

confidence: 99%

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Foreign Body Reaction in Glaucoma Drainage Implant Surgery

Jung

Lee

Kim

et al. 2013

Invest. Ophthalmol. Vis. Sci.

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PURPOSE.To investigate the histopathology of the foreign body reaction (FBR) and the effect of aqueous humor on it in glaucoma drainage implant surgery. METHODS.A glaucoma drainage device was implanted into 20 New Zealand white rabbits. We monitored the histopathology of blebs at microscopic levels from 3 days to 8 weeks postoperatively. Hematoxylin and eosin staining, Masson's trichrome staining, anti-actin and a-smooth muscle immunofluorescence staining, and antiproliferating cell nuclear antigen immunohistochemistry were performed. To observe effects of aqueous humor on FBR, we designed two implant models. One group received a plate with a tube placed in the anterior chamber (experimental group), whereas the other received the plate cut from the tube (control group).RESULTS. Foreign body giant cells were found along the inner border of blebs, and the innermost layer of blebs demonstrated a densely packed collagenous stratum in both groups. The number of foreign body giant cells was suppressed in the experimental group compared with the control group (P < 0.001). Fibroblast division was more active in the experimental group than that in the control group. Masson's trichrome staining demonstrated that the innermost avascular collagenous layer was much thicker in the experimental group than that in the control group (P ¼ 0.021). The extent of a-SMA staining was greater in the experimental group than that in the control group.CONCLUSIONS. In the aqueous humor environment, wound healing around a glaucoma drainage implant revealed a unique FBR with the relatively small number of foreign body giant cells and reinforced fibrotic encapsulation.

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Section: Discussionsupporting

confidence: 48%

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Foreign Body Reaction in Glaucoma Drainage Implant Surgery

Jung

Lee

Kim

et al. 2013

Invest. Ophthalmol. Vis. Sci.

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“…A few studies have already been published in which a slow-release formulation of 5-fluorouracil is described. Collagen plugs,112 polyesters,113 and amniotic membranes114 containing the antimitotic agent were shown to induce a prolonged effect on bleb survival in the standard rabbit model. The effect of a sustained-release dexamethasone implant (Ozurdex ® , Allergan, Irvine, CA, USA) on postoperative wound healing was also investigated in this animal model, and was found to be effective in prolonging bleb survival.…”

Section: Future Perspectivesmentioning

confidence: 99%

Improving patient outcomes following glaucoma surgery: state of the art and future perspectives

Bergen¹,

Velde²,

Vandewalle³

et al. 2014

OPTH

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Of all the treatments currently used to lower intraocular pressure in glaucoma patients, filtration surgery is known to be the most effective. However, in a significant percentage of cases, the constructed channel closes due to excessive scar formation, resulting in surgical failure. The process of postoperative wound healing is characterized by the coagulative and inflammatory phase, followed by the proliferative and repair phase, and finally the remodeling phase. Perioperative antimitotic agents, such as mitomycin C and 5-fluorouracil, are known to modulate the process of wound healing and to improve surgical outcome, but they carry a risk of vision-threatening complications. New alternative strategies to prevent filtration failure, such as inhibition of transforming growth factor-β, vascular endothelial growth factor, and placental growth factor, have shown promising results in the improvement of surgical success. However, it remains necessary to broaden the therapeutic approach by focusing on combined therapies and on extended drug delivery.

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“…One study used 5-FU mixed in a biodegradable collagen plug placed in the silicone drainage tube of the filtration device [98]. In rabbits, improved healing around the tubes was reported, although the study made no experimental comparison between delivery via the modified device and a traditional injection method.…”

Section: Implantablementioning

confidence: 99%

Drug delivery systems for the eye

Kearns

Williams

2009

Expert Review of Medical Devices

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Topical and systemic administration of drugs to the eye is highly inefficient and there is a need for controlled, sustained release, particularly for conditions that affect the posterior segment. Various nonimplantable and implantable drug delivery devices have been developed. Colloidal carriers may allow targeted drug delivery and afford protection to substances that are sensitive to degradation, particularly RNA/DNA-based treatments. Gene therapy and cell transplantation are also starting to emerge as alternatives to conventional pharmacological treatment. There is the potential to use existing ocular devices to deliver drugs. In order to exploit this opportunity, modifications to drugs and devices, along with clarification of the appropriate drug dose, must be undertaken. This review will describe some of the treatment options for ocular disease and barriers to drug delivery, discuss the design of existing drug delivery systems and highlight some of the research into combining drug delivery with existing ocular medical devices.

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Slow release of the antimetabolite 5-fluorouracil (5-FU) from modified Baerveldt glaucoma drains to prolong drain function

Cited by 32 publications

References 23 publications

Foreign Body Reaction in Glaucoma Drainage Implant Surgery

Foreign Body Reaction in Glaucoma Drainage Implant Surgery

Improving patient outcomes following glaucoma surgery: state of the art and future perspectives

Drug delivery systems for the eye

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