Comparison of the effect of adjuvant 5-fluorouracil, low molecular weight heparin and daunomycin in combination with triamcinolone during vitrectomy in advanced retinal detachment

ABSTRACT

To compare the success rate of adjunctive 5-fluorouracil [5-FU] and low molecular weight heparin [LMWH], and daunomycin in combination with triamcinolone during vitrectomy in eyes with retinal detachment [RD] and proliferative vitreoretinopathy [PVR]. In this prospective randomized clinical trial, 69 eyes from 69 patients with RD and PVR [grade B or C] randomized to 3 groups. Group 1 received 5-FU and LMWH [200 microgram/ml 5-FU and 5 IU/ml LMWH, Fragmin]; group 2 received daunomycin [0.5 mg] in 500 cc infusion fluid; and group 3 control group. In all patients, 0.1 cc intravitreal triamcinolone was used during vitrectomy. The patients visited on day 1, week 1, month 1, 3 and 6. Best corrected visual acuity [BCVA] and retinal status compared in the 3 groups. Complete data were available for 60 out of 69 patients. Thirty five patients [58.3%] were male and 25 patients [41.7%] were female. The patient age range was 19-84 years and the mean age was 49. The groups did not have significant difference in age, sex, duration of detachment, severity of PVR, preoperative visual acuity [V/A], lens status, type of tamponade and encircling band and buckle. Postoperative V/A and retina status also was the same in the 3 groups. Perioperative infusion of 5-FU, LMWH and daunomycin does not significantly increase the success rate of patients with RD and PVR comparing to control group. Although visual acuity improvement and retina reattachment rate in group 1 and 2 were better than control group, but statistical analysis failed to show significant difference between the 3 groups