Treatment of
proliferative vitreoretinopathy (PVR) requires a multidimensional approach. Recent studies have focused on pharmacologic techniques to inhibit intraocular cell proliferation by applying
antimetabolite drugs. Side effects associated with these drugs and difficulties in achieving effective concentration inside the eye make
drug delivery an important and difficult part of this approach. We have developed a sustained-release bioerodible device with modifiable release properties for intraocular
drug delivery. In this study, we evaluated the efficacy of the device with two different concentrations of
5-fluorouracil (5-FU) in an experimental model of PVR in rabbit eyes. Both devices showed significant (P < 0.05) efficacy in prevention of PVR. Devices containing 20%
5-FU (total of 1 mg) were 100% effective in prevention of tractional
retinal detachment. No significant complications, other than mild
vitreous hemorrhage in a few cases, were associated with this method. Because pharmacologic
therapy is used as an augmenting method to surgical
therapy, these devices can be easily implanted inside the eye through a sclerotomy at the completion of surgery without any discomfort to patients. Slow release of
drug by this method reduces the incidence of toxicity and increases the efficacy by providing a constant concentration of
drug during the active period of the disease.