A Major Review of Antimetabolites in Glaucoma Therapy

Loon, Seng Chee; Chew, Peter

doi:10.1159/000027428

Cited by 36 publications

(29 citation statements)

References 54 publications

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“…It has been also shown that 5-FU inhibits fibroblast proliferation in tissue cultures [27] . As a result, this drug has been widely used in the treatment of some non-malignant diseases, such as hypertrophic scars, actinic keratosis, trabeculectomy and glaucoma surgery [28,29] . However, fibroblastic cell reaction or 5-FU's fibrotic effects may differ due to its different applications.…”

Section: Discussionmentioning

confidence: 99%

Effects of Locally Applied 5-Fluorouracil on the Prevention of Postmastectomy Seromas in a Rat Model

Koçdor¹,

Yildiz²,

Koçdor³

et al. 2007

Eur Surg Res

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Backgrounds: Seroma formation is the most common complication following mastectomy and axillary dissection (AD). Currently available interventions have aimed at obliterating dead space by inducing fibrosis and through various mechanical methods. Here, 5-fluorouracil (5-FU), used as a sclerosing agent for the prevention of seroma formation, was investigated in a rat mastectomy model. Methods: 20 rats were divided into two groups (5-FU and control). All rats underwent mastectomy and AD. Immediately following the operation, equal volumes of saline and 5-FU were administered under the surgical flaps. One week after the operation, seroma formation and wound-healing processes were evaluated using histopathological and biochemical investigations. Results: 5-FU did not act as a sclerosing agent, yet it was highly effective in preventing seroma formation. The intensity of acute inflammation, vascularity, as well as leukocyte and fibroblast infiltration, were significantly lower in the 5-FU group than the control; the tissue collagen fractions and total seroma collagen contents were found to be similar between the two groups. Conclusions: The mechanisms underlying seroma prevention by 5-FU are probably related to a decrease in the inflammation and angiogenesis rather than a local fibrotic process. Seroma formation may be due to a prolonged inflammatory phase of wound healing.

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Section: Discussionmentioning

confidence: 99%

Effects of Locally Applied 5-Fluorouracil on the Prevention of Postmastectomy Seromas in a Rat Model

Koçdor¹,

Yildiz²,

Koçdor³

et al. 2007

Eur Surg Res

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“…Use of antimetabolites during surgeries could effectively modulate this process; however, it can also cause particular problems and severe side-effects, such as leakage, infection, hypotony, and endophthalmitis [1,2]. Therefore, antifibrotic agents that can modulate wound healing more safely and effectively are desirable.…”

Section: Introductionmentioning

confidence: 99%

Rosiglitazone attenuates activation of human Tenon’s fibroblasts induced by transforming growth factor -β1

Fan

Li²,

Duan

et al. 2012

Graefes Arch Clin Exp Ophthalmol

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“…Various methods have been investigated in order to avoid naturally occurring scarring of the filtering bleb and subsequent to lower the incidence of this detrimental complication. Antimetabolic drugs, 5-fluorouracil (5-FU) or mitomycin C (MMC), are the two most widely used cytotoxic agents for intraoperative or postoperative application 1,2. Despite the positive effect MMC has on filtering surgery success rates, its diffusion into adjacent ocular tissues may lead to toxic effects on cells not targeted during treatment 3–5…”

Section: Introductionmentioning

confidence: 99%

Comparative study between trabeculectomy with photodynamic therapy (BCECF-AM) and trabeculectomy with antimetabolite (MMC) in the treatment of primary open angle glaucoma

Saeed

2012

OPTH

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BackgroundVarious methods have been investigated to avoid postoperative scarring of the filtering bleb in modern glaucoma surgery. Most deal with the application of antimetabolic drugs such as mitomycin C (MMC). 2′,7′-bis-(2-carboxyethyl)-5-(and-6)-carboxyfluorescein, acetoxymethyl ester (BCECF-AM) is a locally acting intracellular photosensitizer which could control and decrease postoperative fibrosis at the trabeculectomy site.PurposeTo compare the effect of photodynamic therapy in combination with trabeculectomy to the effect of MMC combined with the same procedure in controlling postoperative intraocular pressure (IOP) in patients with medically uncontrolled primary open angle glaucoma (1ry OAG).MethodsA randomized controlled clinical trial was conducted on 76 eyes of 76 patients divided into three groups undergoing trabeculectomy, trabeculectomy with BCECF-AM (group A), trabeculectomy with MMC (group B), and trabeculectomy only as a control group (group C). Patients were reviewed postoperatively for clinical evaluation and photo documentation of the blebs with a fundus camera and ultrasonic biomicroscopy (UBM). The desirable effect of the adjunctive material was evaluated according to the clinical efficacy, tolerability, and safety by comparison with the control group.SettingBenha University Hospital, Benha, Egypt.ResultsAfter a mean follow-up of 24 months, all procedures succeeded in lowering IOP. The cumulative probability of complete success at the 24 month follow-up was 91% for group B, compared to 82% and 81.5% for group A and group C, respectively. The percentage of complete success was highest for group B, second highest for group A, and lowest for group C over the follow-up period; however, these differences were not statistically significant (P > 0.05). Regarding the bleb morphology and UBM reflectivity, the differences were not statistically significant (P > 0.05). The mean bleb height and breadth were larger in groups A and B in comparison to group C over the study period. The mean aqueous drainage route was similar in groups A and C, but less than in group B at 3 and 12 months postoperatively. Complications were generally mild and less marked in group A and C than group B.ConclusionCellular photoablation using BCECF-AM seems to be a feasible new method to use in combination with glaucoma filtration surgery. Although MMC might be considered a more potent adjunctive to trabeculectomy in promoting IOP reduction, photodynamic therapy carries relatively less risk of adverse effects and complications. Cellular photoablation using BCECF-AM could be considered efficient, tolerable and relatively safer in managing patients with 1ry OAG. Further studies are necessary to determine the safety and the reliability of this therapy.

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A Major Review of Antimetabolites in Glaucoma Therapy

Cited by 36 publications

References 54 publications

Effects of Locally Applied 5-Fluorouracil on the Prevention of Postmastectomy Seromas in a Rat Model

Effects of Locally Applied 5-Fluorouracil on the Prevention of Postmastectomy Seromas in a Rat Model

Rosiglitazone attenuates activation of human Tenon’s fibroblasts induced by transforming growth factor -β1

Comparative study between trabeculectomy with photodynamic therapy (BCECF-AM) and trabeculectomy with antimetabolite (MMC) in the treatment of primary open angle glaucoma

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