Effects of Cy to sine Arabino side-Impregnated Bioerodible Polymers on Glaucoma Filtration Surgery in Rabbits

Abstract

A prospective, randomized double-masked placebo-controlled study was performed to determine the effects of a bioerodible polymer containing cytosine arabinoside (Ara-C) on the success of full thickness filtration surgery in 21 rabbits. The polymer was a polyanhydride composed of bis(pcarboxyphenoxy) propane and sebacic acid. The polymer and Ara-C (1 mg by weight) were combined and compressed into discs 3-mm and 1-mm thick. Control polymers contained no Ara-C. Posterior lip sclerectomy surgery was performed bilaterally, with one eye randomly receiving the polymer with the Ara-C and the fellow eye receiving the control polymer. All eyes were examined on the first postoperative day and every other day thereafter. Intraocular pressures (IOPs) were found to be significantly lower (p < 0.04) in the experimental eyes during the 5th through the 15th postoperative day, with the mean difference ranging from 3.5 to 6.0 mm Hg. The median number (+/-SE) of days until failure of the filters was 10.5 (+/-0.66) days in the control group and 15.2 (+/-1.94) days in the experimental group, the difference being statistically significant. There were no significant differences between the groups with regard to conjunctival injection, corneal epithelial defects, anterior chamber inflammation, lens changes, or intraoperative or postoperative complications. This study suggests that polymer drug delivery of Ara-C may be a safe and efficacious adjunct in temporarily increasing the success rate of glaucoma filtering surgery in a rabbit model.