Effect of intraoperative 5-fluorouracil and low molecular weight heparin on the outcome of high-risk proliferative vitreoretinopathy

Sunil Ganekal, Syril Dorairaj

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Purpose: To evaluate the efficacy of a combination of 5-fluorouracil (5-FU) and low molecular weight heparin (LMWH) during vitrectomy, as adjuvants in preventing proliferative vitreoretinopathy (PVR). Design: Double-blind, prospective, randomized placebo-controlled trial. Methods: Forty consecutive patients diagnosed with rhegmatogenous retinal detachment with high-risk PVR, were randomized to study and control groups (n = 20 each). Study group (group 1) patients underwent vitrectomy with the use of both intraoperative 5-FU (0.2. mg/ml) and LMWH (5. IU/ml). In the control group (group 2), a similar surgery was performed without the use of adjuvants. Patients were evaluated at 1. month, 3. months and 6. months after surgery. Postoperative retinal reattachment, recurrence of PVR, best-corrected visual acuity and complications at the end of 6. months were compared between the two groups. A Chi-. square statistical analysis was used on all of the outcome measures. Results: At 6months post-surgery, 62.5% of patients had reattached retina. There was no significant difference (Chi-square test showed x2=0.106, P=0.7447, P>0.05) in retinal reattachment in both of the groups. The rate of postoperative PVR in the control group was 55%; in the study group, the rate was 45% (the Chi-square test showed x2=0.4, P=0.5271, P>0.05), which proves statistically insignificant. In addition, there was no statistically significant difference in visual outcomes between the two groups (Chi-square test showed x2=0.1002, P>0.05), no significant difference in the complication rate and drug toxicity was noted between two groups. Conclusions: This study fails to prove the efficacy of the intraoperative use of 5-FU and LMWH in combination as an antiproliferative regiment for the prevention of postoperative PVR or improvement in final visual acuity. At the same time, no significant complications could be attributed to the treatment.

Original languageEnglish (US)
Pages (from-to)257-261
Number of pages5
JournalSaudi Journal of Ophthalmology
Volume28
Issue number4
DOIs
StatePublished - Oct 1 2014

Fingerprint

Proliferative Vitreoretinopathy
Low Molecular Weight Heparin
Fluorouracil
Chi-Square Distribution
Vitrectomy
Control Groups
Visual Acuity
Retinal Detachment
Drug-Related Side Effects and Adverse Reactions
Retina
Randomized Controlled Trials
Placebos
Outcome Assessment (Health Care)
Recurrence

Keywords

  • 5-Fluorouracil
  • Low molecular weight heparin
  • Proliferative vitreoretinopathy
  • Rhegmatogenous retinal detachment

ASJC Scopus subject areas

  • Ophthalmology

Cite this

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title = "Effect of intraoperative 5-fluorouracil and low molecular weight heparin on the outcome of high-risk proliferative vitreoretinopathy",
abstract = "Purpose: To evaluate the efficacy of a combination of 5-fluorouracil (5-FU) and low molecular weight heparin (LMWH) during vitrectomy, as adjuvants in preventing proliferative vitreoretinopathy (PVR). Design: Double-blind, prospective, randomized placebo-controlled trial. Methods: Forty consecutive patients diagnosed with rhegmatogenous retinal detachment with high-risk PVR, were randomized to study and control groups (n = 20 each). Study group (group 1) patients underwent vitrectomy with the use of both intraoperative 5-FU (0.2. mg/ml) and LMWH (5. IU/ml). In the control group (group 2), a similar surgery was performed without the use of adjuvants. Patients were evaluated at 1. month, 3. months and 6. months after surgery. Postoperative retinal reattachment, recurrence of PVR, best-corrected visual acuity and complications at the end of 6. months were compared between the two groups. A Chi-. square statistical analysis was used on all of the outcome measures. Results: At 6months post-surgery, 62.5{\%} of patients had reattached retina. There was no significant difference (Chi-square test showed x2=0.106, P=0.7447, P>0.05) in retinal reattachment in both of the groups. The rate of postoperative PVR in the control group was 55{\%}; in the study group, the rate was 45{\%} (the Chi-square test showed x2=0.4, P=0.5271, P>0.05), which proves statistically insignificant. In addition, there was no statistically significant difference in visual outcomes between the two groups (Chi-square test showed x2=0.1002, P>0.05), no significant difference in the complication rate and drug toxicity was noted between two groups. Conclusions: This study fails to prove the efficacy of the intraoperative use of 5-FU and LMWH in combination as an antiproliferative regiment for the prevention of postoperative PVR or improvement in final visual acuity. At the same time, no significant complications could be attributed to the treatment.",
keywords = "5-Fluorouracil, Low molecular weight heparin, Proliferative vitreoretinopathy, Rhegmatogenous retinal detachment",
author = "Sunil Ganekal and Syril Dorairaj",
year = "2014",
month = "10",
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doi = "10.1016/j.sjopt.2014.03.005",
language = "English (US)",
volume = "28",
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issn = "1319-4534",
publisher = "King Saud University",
number = "4",

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TY - JOUR

T1 - Effect of intraoperative 5-fluorouracil and low molecular weight heparin on the outcome of high-risk proliferative vitreoretinopathy

AU - Ganekal, Sunil

AU - Dorairaj, Syril

PY - 2014/10/1

Y1 - 2014/10/1

N2 - Purpose: To evaluate the efficacy of a combination of 5-fluorouracil (5-FU) and low molecular weight heparin (LMWH) during vitrectomy, as adjuvants in preventing proliferative vitreoretinopathy (PVR). Design: Double-blind, prospective, randomized placebo-controlled trial. Methods: Forty consecutive patients diagnosed with rhegmatogenous retinal detachment with high-risk PVR, were randomized to study and control groups (n = 20 each). Study group (group 1) patients underwent vitrectomy with the use of both intraoperative 5-FU (0.2. mg/ml) and LMWH (5. IU/ml). In the control group (group 2), a similar surgery was performed without the use of adjuvants. Patients were evaluated at 1. month, 3. months and 6. months after surgery. Postoperative retinal reattachment, recurrence of PVR, best-corrected visual acuity and complications at the end of 6. months were compared between the two groups. A Chi-. square statistical analysis was used on all of the outcome measures. Results: At 6months post-surgery, 62.5% of patients had reattached retina. There was no significant difference (Chi-square test showed x2=0.106, P=0.7447, P>0.05) in retinal reattachment in both of the groups. The rate of postoperative PVR in the control group was 55%; in the study group, the rate was 45% (the Chi-square test showed x2=0.4, P=0.5271, P>0.05), which proves statistically insignificant. In addition, there was no statistically significant difference in visual outcomes between the two groups (Chi-square test showed x2=0.1002, P>0.05), no significant difference in the complication rate and drug toxicity was noted between two groups. Conclusions: This study fails to prove the efficacy of the intraoperative use of 5-FU and LMWH in combination as an antiproliferative regiment for the prevention of postoperative PVR or improvement in final visual acuity. At the same time, no significant complications could be attributed to the treatment.

AB - Purpose: To evaluate the efficacy of a combination of 5-fluorouracil (5-FU) and low molecular weight heparin (LMWH) during vitrectomy, as adjuvants in preventing proliferative vitreoretinopathy (PVR). Design: Double-blind, prospective, randomized placebo-controlled trial. Methods: Forty consecutive patients diagnosed with rhegmatogenous retinal detachment with high-risk PVR, were randomized to study and control groups (n = 20 each). Study group (group 1) patients underwent vitrectomy with the use of both intraoperative 5-FU (0.2. mg/ml) and LMWH (5. IU/ml). In the control group (group 2), a similar surgery was performed without the use of adjuvants. Patients were evaluated at 1. month, 3. months and 6. months after surgery. Postoperative retinal reattachment, recurrence of PVR, best-corrected visual acuity and complications at the end of 6. months were compared between the two groups. A Chi-. square statistical analysis was used on all of the outcome measures. Results: At 6months post-surgery, 62.5% of patients had reattached retina. There was no significant difference (Chi-square test showed x2=0.106, P=0.7447, P>0.05) in retinal reattachment in both of the groups. The rate of postoperative PVR in the control group was 55%; in the study group, the rate was 45% (the Chi-square test showed x2=0.4, P=0.5271, P>0.05), which proves statistically insignificant. In addition, there was no statistically significant difference in visual outcomes between the two groups (Chi-square test showed x2=0.1002, P>0.05), no significant difference in the complication rate and drug toxicity was noted between two groups. Conclusions: This study fails to prove the efficacy of the intraoperative use of 5-FU and LMWH in combination as an antiproliferative regiment for the prevention of postoperative PVR or improvement in final visual acuity. At the same time, no significant complications could be attributed to the treatment.

KW - 5-Fluorouracil

KW - Low molecular weight heparin

KW - Proliferative vitreoretinopathy

KW - Rhegmatogenous retinal detachment

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