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Article: Adjuvant 5-fluorouracil and heparin prevents proliferative vitreoretinopathy: Results from a randomized, double-blind, controlled clinical trial

TitleAdjuvant 5-fluorouracil and heparin prevents proliferative vitreoretinopathy: Results from a randomized, double-blind, controlled clinical trial
Authors
Issue Date2001
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ophtha
Citation
Ophthalmology, 2001, v. 108 n. 7, p. 1179-1183 How to Cite?
AbstractPurpose: To assess the safety and efficacy of adjuvant combination therapy using 5-fluorouracil (5-FU) and low molecular weight heparin (LMWH) for prevention of proliferative vitreoretinopathy (PVR) after vitrectomy and retinal reattachment surgery. Design: Prospective randomized, double-masked, placebo controlled trial. Participants: One hundred seventy-four high-risk patients were randomized to receive either 5-FU and LMWH therapy or placebo. Patients were selected from ali patients undergoing primary vitrectomy for rhegmatogenous retinal detachment. Method: Results of standard surgery with 5-FU and LMWH therapy or placebo were compared at the 6-month follow-up. Main Outcome Measures: Development of postoperative PVR, retinal reattachment at 6 months after surgery, single operation reattachment rate, number of reoperations, and best-corrected visual acuity. Results: There were 87 patients in the 5-FU and LMWH therapy group and 87 in the placebo group. The incidence of postoperative PVR was significantly lower (P = 0.02) in the 5-FU and LMWH therapy compared with the placebo group. In 26.4% (23/87) of the placebo group and in 12.6% (11/87) of the 5-FU and LMWH group, postoperative PVR developed. In the 5-FU and LMWH group, the number of patients undergoing more than one operation was 19.5% (17/87) and the number of reoperations resulting from PVR was 52.9% (9/17). In the placebo group, the number of patients undergoing more than one operation was 25.3% (22/87) and the number of reoperations resulting from PVR was 72.7% (16/22). The difference in visual acuity was not statistically different in the two treatment groups, although those patients in whom postoperative PVR developed tended to have poorer vision (P < 0.0001). There were no differences in complication rates between the two groups. Conclusions: There is a significant reduction in the incidence of postoperative PVR in patients receiving the 5-FU and LMWH therapy and in the reoperation rate resulting from PVR. This trial shows that incidence of PVR can be reduced with inexpensive and simple pharmacologic treatment with 5-FU and LMWH and should be used routinely in the treatment of patients at risk of developing PVR. © 2001 by the American Academy of Ophthalmology.
Persistent Identifierhttp://hdl.handle.net/10722/146258
ISSN
2015 Impact Factor: 6.75
2015 SCImago Journal Rankings: 4.745
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorAsaria, RHYen_HK
dc.contributor.authorKon, CHen_HK
dc.contributor.authorBunce, Cen_HK
dc.contributor.authorCharteris, DGen_HK
dc.contributor.authorWong, Den_HK
dc.contributor.authorKhaw, PTen_HK
dc.contributor.authorAylward, GWen_HK
dc.date.accessioned2012-04-10T01:49:45Z-
dc.date.available2012-04-10T01:49:45Z-
dc.date.issued2001en_HK
dc.identifier.citationOphthalmology, 2001, v. 108 n. 7, p. 1179-1183en_HK
dc.identifier.issn0161-6420en_HK
dc.identifier.urihttp://hdl.handle.net/10722/146258-
dc.description.abstractPurpose: To assess the safety and efficacy of adjuvant combination therapy using 5-fluorouracil (5-FU) and low molecular weight heparin (LMWH) for prevention of proliferative vitreoretinopathy (PVR) after vitrectomy and retinal reattachment surgery. Design: Prospective randomized, double-masked, placebo controlled trial. Participants: One hundred seventy-four high-risk patients were randomized to receive either 5-FU and LMWH therapy or placebo. Patients were selected from ali patients undergoing primary vitrectomy for rhegmatogenous retinal detachment. Method: Results of standard surgery with 5-FU and LMWH therapy or placebo were compared at the 6-month follow-up. Main Outcome Measures: Development of postoperative PVR, retinal reattachment at 6 months after surgery, single operation reattachment rate, number of reoperations, and best-corrected visual acuity. Results: There were 87 patients in the 5-FU and LMWH therapy group and 87 in the placebo group. The incidence of postoperative PVR was significantly lower (P = 0.02) in the 5-FU and LMWH therapy compared with the placebo group. In 26.4% (23/87) of the placebo group and in 12.6% (11/87) of the 5-FU and LMWH group, postoperative PVR developed. In the 5-FU and LMWH group, the number of patients undergoing more than one operation was 19.5% (17/87) and the number of reoperations resulting from PVR was 52.9% (9/17). In the placebo group, the number of patients undergoing more than one operation was 25.3% (22/87) and the number of reoperations resulting from PVR was 72.7% (16/22). The difference in visual acuity was not statistically different in the two treatment groups, although those patients in whom postoperative PVR developed tended to have poorer vision (P < 0.0001). There were no differences in complication rates between the two groups. Conclusions: There is a significant reduction in the incidence of postoperative PVR in patients receiving the 5-FU and LMWH therapy and in the reoperation rate resulting from PVR. This trial shows that incidence of PVR can be reduced with inexpensive and simple pharmacologic treatment with 5-FU and LMWH and should be used routinely in the treatment of patients at risk of developing PVR. © 2001 by the American Academy of Ophthalmology.en_HK
dc.languageengen_US
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ophthaen_HK
dc.relation.ispartofOphthalmologyen_HK
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshDouble-Blind Methoden_US
dc.subject.meshDrug Therapy, Combinationen_US
dc.subject.meshFemaleen_US
dc.subject.meshFluorouracil - Therapeutic Useen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHeparin, Low-Molecular-Weight - Therapeutic Useen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshRetinal Detachment - Surgeryen_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshSafetyen_US
dc.subject.meshVisual Acuityen_US
dc.subject.meshVitrectomy - Adverse Effectsen_US
dc.subject.meshVitreoretinopathy, Proliferative - Etiology - Prevention & Controlen_US
dc.titleAdjuvant 5-fluorouracil and heparin prevents proliferative vitreoretinopathy: Results from a randomized, double-blind, controlled clinical trialen_HK
dc.typeArticleen_HK
dc.identifier.emailWong, D: shdwong@hku.hken_HK
dc.identifier.authorityWong, D=rp00516en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/S0161-6420(01)00589-9en_HK
dc.identifier.pmid11425671en_HK
dc.identifier.scopuseid_2-s2.0-0034977919en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0034977919&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume108en_HK
dc.identifier.issue7en_HK
dc.identifier.spage1179en_HK
dc.identifier.epage1183en_HK
dc.identifier.isiWOS:000169545200017-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridAsaria, RHY=6603036104en_HK
dc.identifier.scopusauthoridKon, CH=6701582606en_HK
dc.identifier.scopusauthoridBunce, C=7005268305en_HK
dc.identifier.scopusauthoridCharteris, DG=7003299563en_HK
dc.identifier.scopusauthoridWong, D=7401536078en_HK
dc.identifier.scopusauthoridKhaw, PT=7006578947en_HK
dc.identifier.scopusauthoridAylward, GW=7007021912en_HK

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