To compare the effects of mitomycin C and 5-fluorouracil biological delivery film on glaucoma filtering surgery in rabbits

Abstract

Objeetive To evaluate the safety and effectiveness of glaucoma filtering surgery performed with the adjunctive use biological delivery film and compare the anti-proliferation effects of mitomycin C(MMC)and 5-fluorouracil(5-Fu)biological delivery films on glaucoma filtering surgery.Methods The 5-Fu and MMC were used as a model drug,and the biological membranes with chitosan as carrier were prepared through solvent volatilization.5-Fu and MMC biological delivery films were prepared by covalent coupiing of 12μg 5-Fu or MMC respectively.The rabbits received no implant were control.The other groups received biological delivery film with no drug,5-Fu and MMC.Glaucoma filtering surgery were performed in four groups,a beveled 24-gauge intravenous cannula was as a drainage tube,the biological delivery films with no drug,5-Fu and MMC were sutured under scleral flaps.Intraocular pressure(IOP)measurements were recorded before surgery and starting from postoperative day 1,3,5,7,14,21 and 28 using a Tonopen.Bleb survival and anterior segment were examined with slit-lamp and photographed.Two animals from each group were sacrificed on days 28,yielding a total of 8 eyes for histopathological study,each specimen of comeas and lens was examined at 28 days by transmission and scanning electron microscopy.Results No differences were noted between the control group and the three experimental groups in mean preoperative IOPs.In rabbits receiving 12μ g MMC ,the differences of IOP from preoperative levels up to 28 days following surgery was statistically significant (F=26.866,P＜0.01 ).The rabbits received no implant (control) and 12μg 5-Fu,the differences of IOP from preoperative levels up to 14 days following surgery was statistically significant (F=13.467,6.567 respectively,P＜0.01 ).The rabbits received biological delivery film with no drug,the differences of IOP from preoperative levels up to 7 days following surgery was statistically significant (F=11.426,P＜0.01).The filtering blobs were only minimally different.The filtering blebs failure time was significantly longer in MMC and 5-Fu group (14 days) than other two groups (7 days).Conclusions This study provides evidence that the 5-Fu and MMC biological delivery films can significantly improve the success of filtering procedures and are safety,MMC can effectively prolongs bleb survival in rabbits,The maintenance of ocular hypotension and bleb survival along with the reduction in anterior segment complications supports the idea MMC will be more effective than use of 5-Fu in improving the success rate of filtering surgery. Key words: Chitosan; Delivery; MMC; 5-Fu