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Systemic absorption of 5-fluorouracil during vitrectomy.
Onne Creten1, Werner Spileers, Peter Stalmans
1Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium.
American Journal of Ophthalmology
|July 4, 2006
Summary
Systemic absorption of 5-fluorouracil (5FU) occurred in patients undergoing vitrectomy. A 5FU metabolite, FBAL, was detected in urine up to 48 hours post-surgery, suggesting caution in pediatric patients.
Area of Science:
- Ophthalmology
- Pharmacology
- Oncology
Background:
- Proliferative vitreoretinopathy (PVR) is a serious complication following retinal detachment surgery.
- 5-fluorouracil (5FU) is sometimes used intraoperatively to inhibit fibroblast proliferation and prevent PVR.
- The potential for systemic absorption of intraocular 5FU has not been well-established.
Purpose of the Study:
- To investigate the systemic absorption of 5-fluorouracil (5FU) when administered via vitrectomy infusion fluid.
- To quantify the presence of a 5FU metabolite in patient urine samples post-vitrectomy.
Main Methods:
- A clinical study involving two patients undergoing vitrectomy.
- Intraoperative infusion of 5-fluorouracil (5FU).
- Measurement of alpha-fluoro-beta-alanine (FBAL), a catabolite of 5FU, in serial urine samples collected up to 48 hours post-surgery.
Main Results:
- The 5FU metabolite, FBAL, was detected in the urine of both patients.
- FBAL was present in urine samples collected up to 48 hours after the vitrectomy procedure.
- Urine concentrations of FBAL varied significantly between the two patients.
Conclusions:
- Intraoperative use of 5-fluorouracil (5FU) in vitrectomy infusion fluid can lead to significant systemic absorption.
- The presence of FBAL in urine indicates systemic exposure to 5FU.
- Given the potential for systemic absorption, the use of 5FU in pediatric patients undergoing vitrectomy may warrant reconsideration.