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KMID : 0350519930460041699
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Journal of Catholic Medical College
1993 Volume.46 No. 4 p.1699 ~ p.1713
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Efficacy and Toxicity of 5-Fluorouracil and Mitomycin-C on Glaucoma Filtration Surgery in Rabbits
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Abstract
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The authors investigated the efficacy and toxicity of 5-fluorouraci(5-FU) and mitomycin-C (MMC), which can promote the success rate of the glaucoma filtration surgery(GFS).
One hundred and twenty rabbits were divided into four groups : the first control group(BSS) was treated a single 5-minutes intraoperative exposure to the balanced salt solution(BSS) on GFS. The second group(5-FUSC) injected 5 mg/ml)
subconjunctivally
ten times after GFS : everyday at the first week and every other day at the second week. The third(5-FU) and fourth one (MMC) was applicated a single 5-minutes intraoperative exposure to 5-FU(solution of 50 mg/ml) and MMC(solution of 0.2 mg/ml)
on
GFS
respectively
We observed the effect of 5-FU and MMC on the bleb fomation and complications using slit-lamp biomicroscope for twelve weeks. At the two and twelve weeks after GFS, the inhibition of fibroblast proliferation and fibrosis were observed using light
microscope. At the third day after GFS, the ultrastructural changes of corneal epithelial and endothelial cells were found using scanning electron microscope. Ptherwise, at the twenty-four weeks after GFS, we made an observation on the
degenerative
changes of the scleral fiproblasts using transmission electron microscope.
@ES The results were as follows :
@EN 1. The bleb formation in a each group of BSS, 5-FUSC, 5-FU and MMC were 0 %, 26.7 %, 16.7 % and 100 % at the 4 weeks after GFS, and 0 %, 0 %, 0 % and 73.3 % at the 8 weeks after GFS. Respectively. The extent of inhibition of fibrosis and
fibroblast
prolifaration were greater in the order of MMC, 5-FU, 5-FUSC and BSS group at the 2 weeks after GFS. At the 12 weeks after GFS, there was no conspicuous statistic difference(P>0.05) between 5-FU group, but significant differences(P<0.001) in the
BSS and
MMC groups.
2. Postoperative complications were developed in the experimental groups : 6 corneal epithelial erosions(20 %), 3 corneal hazes(10 %), 1 bleb perforation(3.3 %), 1 bleb perforation(3.3 %) in 5-FUSC group, 2 corneal hazes(6.7 %), 1 bled
infection(3.3 %)
in 5-FU group, and 2 symblepharons(6.7 %) in MMC group.
3. Histologically, the infiltration of lymphocytes and the proliferation of fibroblasis, capillaries, collagenous fibers and reticulin fibers and reticulin fibers were decreased in the order of MMC, 5-FU, 5-FUSC and BSS group.
4. Under the scanning electron microspscope, the most serious degenerative changes of the corneal epithelial cells were occurred in 5-FUSC group, while slight changes in 5-FU group. But these changes could not be seen in MMC and BSS group. And
there
was no evidence of corneal endothelial cell damage in all groups.
5. Under the transmission electron microscope, the most profound degenerative changes of the scleral fibroblasts were observed in 5-FU group, and followed by an order of MMC, 5-FUSC and BSS group. From these results, we concluded that the dosage
and
application method of 5-FU and MMC should be decided very carefully and further research will be necessary to find out the optimal dosage with minimum toxicity.
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KEYWORD
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