Comparison of the Effect of Adjuvant 5-Fluorouracil, Low Molecular Weight Heparin and Daunomycin in Compination with Triamcinolone during Vitrectomy in Advanced Retinal Detachment

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). 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 5-FU 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. 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. 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.