Inhibition of posterior capsule opacification by an intraocular-lens-bound sustained drug delivery system: An experimental animal study and literature review

Tetz, Manfred; Ries, Marcus W.; Lucas, Christopher; Stricker, H.; Völcker, H. E.

doi:10.1016/s0886-3350(96)80120-9

Cited by 59 publications

(46 citation statements)

References 23 publications

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“…DNR has increasingly been used to improve the success rate of ocular surgeries, including strabismus surgery, 7 pterygium surgery, 8 retinal detachment surgery, 9 and in the prevention of PCO following cataract extraction. 10,11 Dadeya et al 16,6 evaluated the safety and efficacy of intraoperative 0.02% DNR in strabismus surgery and pterygium surgery. In strabismus surgery, DNR was applied subconjunctivally over the surface of the extra ocular muscle and bare sclera for 3 min in patients undergoing second surgical procedure.…”

Section: Daunorubicinmentioning

confidence: 99%

“…They concluded that DNR seemed to be effective to suppress reproliferation, but that care should be taken to avoid postoperative complications. 9,[22][23][24][25] Some workers 10,11 have performed research into use of DNR as an agent for preventing PCO. They noted that DNR could effectively inhibit the proliferation of human lens epithelial cells in vitro at the concentration of 0.5 mg/ml, almost reaching the greatest effect at the concentration of 7.5 mg/ml.…”

Section: Daunorubicinmentioning

confidence: 99%

“…6 The antifibroblastic action of DNR has been used both in animal studies and in human subjects to improve the success rate of various ophthalmic surgeries, including strabismus surgery, 7 pterygium surgery, 8 and retinal detachment surgery, 9 and in the prevention of posterior capsular opacification (PCO) following cataract extraction. 10,11 In glaucoma, DNR has been used experimentally and in human subjects to improve the success rate of high-risk GFS by way of a biodegradable slow-release subconjunctival (s/c) implant, as preoperative and postoperative s/c injections following trabeculectomy. [12][13][14][15] In our study, we evaluated the efficacy and safety of intraoperative use of DNR in drug-modulated trabeculectomy.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of efficacy and safety of daunorubicin in glaucoma filtering surgery

Varma

Sihota

Agarwal

2006

Eye

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Purpose To evaluate the intraocular pressure (IOP)-lowering effect and ocular side effects of daunorubicin (DNR) in drug-modulated trabeculectomy. Methods A prospective pilot study was conducted in which 21 Asian patients of Indian origin with high risk factors for failure of trabeculectomy were recruited. An approval from research ethics committee and an informed consent from every patient included in the study were obtained. DNR, an antimetabolite with known antifibroblastic action was used intraoperatively. A limbusbased conjunctival flap followed by conventional trabeculectomy was performed in all eyes. During trabeculectomy, a cellulose sponge soaked in 0.2 mg/ml DNR was applied for 3 min at the proposed site of trabeculectomy before preparation of the partial thickness scleral flap. A regular followup was carried out for 1 year where parameters including visual acuity, IOP by applanation tonometry, and slit lamp examination were performed on each visit. An IOP of 21 mmHg or less was taken as criteria for success. Results Following DNR trabeculectomy, the IOP was lowered from baseline preoperative value of 36.1975.9 to 16.0572.52 mmHg at the end of 1 year. Success rate of 81% (17 out of 21 patients) was noted. None of the patients developed corneal epithelial toxicity, hypotony maculopathy, or choroidal detachment. Conclusion The authors feel that intraoperative daunorubicin is safe and effective in lowering IOP in high-risk surgical cases of glaucoma. However, a much larger cohort study over a considerable number of years will eventually demonstrate its safety.

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Section: Daunorubicinmentioning

confidence: 99%

Section: Daunorubicinmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of efficacy and safety of daunorubicin in glaucoma filtering surgery

Varma

Sihota

Agarwal

2006

Eye

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“…Thus, we have in this investigation confirmed and extended previous studies by us [20] and others [24][25][26][27][28] showing a peak in inflammation and LEC proliferative activity on day 1 after surgery. The wet weight of the lens capsule has previously been used in a number of experimental studies to quantitate after-cataract [12][13][14][15][16]. In both protocols 1 and 2 in this study, the wet weight of the capsule including the aftercataract increased over the 56-day-long experimental period.…”

Section: Discussionmentioning

confidence: 92%

“…The wet weight of the after-cataract has been used as a method of quantification in several studies [12][13][14][15][16]. However, the development of after-cataract in the rabbit has not been thoroughly investigated.…”

Section: Introductionmentioning

confidence: 99%

Development of Posterior Capsule Opacification in the Rabbit

Wallentin

Lundgren²,

Holmén³

et al. 2002

Ophthalmic Res

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Purpose: The aim of the present study was to characterize the development of after-cataract in the rabbit by measuring its wet weight, protein, DNA and glycosaminoglycan (GAG) contents and using Scheimpflug and slitlamp analysis. Further, aqueous humor (AqH) leukocytes, protein and lens epithelial cell proliferation activity were determined. Methods: AqH was collected and capsular bags including after-cataract were dissected free on days 0, 1, 7, 14, 28 and 56 after cataract surgery. The wet weights were determined and the contents of DNA, protein and GAG in the capsular bags including after-cataract were analyzed. AqH was analyzed for leukocytes, protein and proliferative activity. In another set of experiments, rabbit eyes were analyzed by the Scheimpflug technique and slitlamp examination on days 0, 1, 7, 14, 28 and 56 after cataract surgery. The wet weight of the capsular bag with the after-cataract was also determined. Results: An increase was found in the wet weight (480%) and the contents of protein (221%), DNA (945%) and GAG (336%) of the capsular bags including after-cataract during the experimental period. In the AqH, all 3 variables measured, leukocytes, protein and proliferative activity, reached their highest levels on day 1 after surgery. In the second set of experiments, the wet weight of the capsular bag including after-cataract increased by 391% during the 56-day experimental period. Posterior capsule opacification (PCO), as measured by Scheimpflug analysis, increased from 0.8 to 81.7% and the scores of Elschnig’s pearls as well as fibrosis, analyzed by slitlamp, increased from 0.0 to 2.8 and 3.0, respectively. Conclusions: This study shows that the same components that are reported to be important in human PCO are also components of PCO in the rabbit. Thus, the rabbit model seems to accurately reflect human PCO development, and because PCO develops much faster in rabbits that would make the rabbit model suitable for studies to elucidate human PCO development.

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Quantitative Comparison of Posterior Capsule Opacification After Polymethylmethacrylate, Silicone, and Soft Acrylic Intraocular Lens Implantation

Hayashi

Hayashi²,

Nakao³

et al. 1998

Arch Ophthalmol

176

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To quantitatively compare the extent of posterior capsule opacification (PCO) after polymethylmethacrylate (PMMA), silicone, and soft acrylic intraocular lens implantation. Patients and Methods: A total of 240 eyes from 240 patients undergoing implant surgery were randomized into 3 groups based on the type of lens implanted: PMMA, silicone, and soft acrylic. The density value of PCO in 185 eyes was quantitated approximately 2 years after surgery by a new measurement method using the Scheimpflug videophotography system. Results: Twenty-one eyes (30.4%) in the PMMA group, 4 (5.7%)inthesiliconegroup,and2(2.7%)intheacrylicgroup hadalreadyundergoneNd:YAGlaserposteriorcapsulotomy. The mean ± SD PCO values were 26.3 ± 12.2 computercompatible tape steps (CCT) in the PMMA group, 12.0 ± 8.3 CCT in the silicone group, and 16.0 ± 10.3 CCT in the acrylic group. The PCO value in the PMMA group was significantly greater than that in the silicone or acrylic group (PϽ.001). The visual acuity loss in the PMMA group was also greater than that in the silicone or acrylic group (PϽ.001). Conclusion: Based on the PCO value and capsulotomy rate, the PCO was more extensive with the PMMA lens than with either the silicone or soft acrylic lens, which led to visual acuity loss.

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Inhibition of posterior capsule opacification by an intraocular-lens-bound sustained drug delivery system: An experimental animal study and literature review

Cited by 59 publications

References 23 publications

Evaluation of efficacy and safety of daunorubicin in glaucoma filtering surgery

Evaluation of efficacy and safety of daunorubicin in glaucoma filtering surgery

Development of Posterior Capsule Opacification in the Rabbit

Quantitative Comparison of Posterior Capsule Opacification After Polymethylmethacrylate, Silicone, and Soft Acrylic Intraocular Lens Implantation

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