Antiproliferative Effect and Safety of 5-Fluorouracil and Heparin in the Treatment of Proliferative Vitreoretinopathy

ABSTRACT

PURPOSE: Proliferative vitreoretinopathy (PVR) is a major cause of recurrence and failure after retinal reattachment surgery. We assessed the effect and safety of adjuvant combination therapy using 5-Fluorouracil (5-FU) and low molecular weight heparin (LMWH) for prevention of PVR after vitrectomy. METHODS: Infusion fluid supplemented with 200 micro gram/mln of 5-FU and 5 IU/ml of LMWH was used during vitrectomy for rhegmatogenous retinal detachment in 21 patients with PVR. Anatomical results, the occurrence of postoperative PVR, and best corrected visual acuity were assessed retrospectively after a minimum of 6-month follow-up. The occurrence of complication was investigated in 27 eyes including an additional 6 eyes without PVR. RESULTS: The primary success rate was 85.7% (18/21) and the incidence of postoperative PVR was 14.3% (3/21). There was hyphema or vitreous hemorrhage in 3 eyes (14.3%), and significant corneal edema in 1 eye (4.8%) immediately after operation. Those complications were resolved without surgical management. There was intraocular pressure elevation (47.6%), and progression of cataract (23.8%) after operation. Those were controlled with antiglaucoma medication or operation. CONCLUSIONS: The use of 5-FU and LMWH is relatively safe and is suggested to have an antiproliferative effect.