COMPARISON OF THE EFFECT OF ADJUVANT 5-FLUOROURACIL, LOW MOLECULAR WEIGHT HEPARIN AND DAUNOMYCIN IN COMBINATION WITH TRIAMCINOLONE DURING VITRECTOMY IN ADVANCED RETINAL DETACHMENT

Purpose: To compare the success rate of adjunctive 5-fluorouracil (5-FU) and low molecular weight heparin (LMWH), and daunomycin in combination with triamcinolone during vitrectomy in eyes with retinal detachment (RD) and proliferative vitreoretinopathy (PVR). Methods: In this prospective randomized clinical trial, 69 eyes from 69 patients with RD and PVR (grade B or C) randomized to 3 groups. Group 1: received 5-FU and LMWH (200 microgram/ml 5FU and 5 IU/ml LMWH, Fragmin); group 2: received daunomycin (0.5 mg) in 500 cc infusion fluid; and group 3: control group. In all patients, 0.1 cc intravitreal triamcinolone was used during vitrectomy. The patients visited on day 1, week 1, month 1, 3 and 6. Best corrected visual acuity (BCVA) and retinal status compared in the 3 groups. Results: Complete data were available for 60 out of 69 patients. Thirty five patients (58.3%) were male and 25 patients (41.7%) were female. The patient age range was 19-84 years and the mean age was 49. The groups did not have significant difference in age, sex, duration of detachment, severity of PVR, preoperative visual acuity (V/A), lens status, type of tamponade and encircling band and buckle. Postoperative V/A and retina status also was the same in the 3 groups. Conclusion: Perioperative infusion of 5-FU, LMWH and daunomycin does not significantly increase the success rate of patients with RD and PVR comparing to control group. Although visual acuity improvement and retina reattachment rate in group 1 and 2 were better than control group, but statistical analysis failed to show significant difference between the 3 groups.