homoharringtonine and Glaucoma

To study the antiproliferative effects of homoharringtonine (Hh) on glaucoma filtering surgery.. In a randomized control clinical trial, 78 patients (88 eyes) with refractory glaucoma underwent trabeculectomy with and without Hh. In the Hh-treated eyes (n = 46), the therapeutic dose of Hh was: intraoperative application of Hh 0.4 mg and postoperative subconjunctival injections of Hh 0.62 +/- 0.20 mg (ranged 0.53 - 0.75 mg). In the control eyes (n = 42), Hh was not used. The follow-up period was 18 to 48 months, and the data were analyzed by using the life-table method of Kaplan-Meier.. The cumulative success probability in Hh group was 84.5% and that in control group was 50.9%, the difference being significant (P < 0.05). The cumulative percentage of functioning bleb in Hh group was 84.2% and that in control group was 52.9% (P < 0.05). The rates of corneal erosion were 23.9% and 7.1%, and the rates of conjunctival wound leak were 6.5% and 2.4% in Hh and control group respectively. There was no significant change in corneal endothelial density following the use of Hh (P > 0.05).. The study indicates that Hh is a safe and effective antiproliferative agent for the use in glaucoma filtering surgery, it not only can increase the success probability considerably, but also maintain at least the postoperative IOP at relatively low normal level for 3 years.

Topics: Adult; Female; Filtration; Glaucoma; Harringtonines; Homoharringtonine; Humans; Male; Postoperative Complications

With a prospective, randomized and double-masked control method, homoharringtonine(H.H) and 5-Fluorouracil (5-FU) were used in filtering surgery. We compared the effect and side effect of H.H with those of 5-FU. 24 eyes were in H.H group and 23 eyes in 5-FU group. An average follow-up of 18 months revealed: (1) the cumulative percentage of functioning bleb in H.H group (84.9%) was significantly higher than that in 5-FU group (62.2%) (P < 0.05); (2) the cumulative surgical success rate in H.H group (85.7%) was significantly higher than that in 5-FU group (61.1%) (P < 0.05); (3) the rate of corneal erosion in H.H group (20.8%) was significantly lower than that in 5-FU group (52.2%) (P < 0.05), the difference of other complications between H.H group and 5-FU group was not significant.

Topics: Adolescent; Adult; Double-Blind Method; Female; Fluorouracil; Glaucoma; Harringtonines; Homoharringtonine; Humans; Male; Middle Aged; Prospective Studies; Sclera; Trabeculectomy

To observe the inhibitory action of homoharringtonine liposome during the healing process of wounds in the filtering sites.. Posterior sclerectomies were performed in 14 rabbits. Postoperatively one eye of each rabbit received subconjunctival injections of HH liposome and fellow eye received saline injection in a randomized masked fashion.. Fourteen days after operation the IOP of experimental eyes reduced significantly (P < 0.01) as compared with the controlled eyes, and the number of remaining filtering blebs increased noticeably (P < 0.05). Pathohistological examination revealed that the number of fibroblasts per square micron in the filtering sites and the thickness of the scars in the center of the filtering sites of the experimental eyes were less than those of the controlled eyes. No serious ocular toxic and side effects were found.. This experiment suggest that homoharringtonine liposome can markedly inhibit the scar formation of filtering sites after glaucoma filtering surgery, promote the formation of filtering blebs, and provide an experimental evidence for its clinical use in future.

Topics: Animals; Cicatrix; Filtering Surgery; Glaucoma; Harringtonines; Homoharringtonine; Liposomes; Postoperative Period; Rabbits

Homoharringtonine (HHT), a Chinese herbal drug, was used in the form of liposome or solution as an adjunct to glaucoma filtration surgery in rabbits to determine its effect in preventing closure of sclerostomy.. Forty rabbits that underwent a standard posterior-lip sclerectomy in both eyes were divided into 5 post-operative groups. Group 1 received subconjunctival HHT liposomes (0.025%). Group 2 received subconjunctival blank liposomes and served as control. Group 3 and 5 received subconjunctival HHT solution at low (0.025%) and high (0.1%) doses respectively. Group 4 received subconjunctival normal saline and served as control. Intraocular pressure, interval between operation and bleb failure, rate of scleral fistula occlusion and ocular toxicity were determined in each group.. Subconjunctival treatment with HHT solution at a high dose transiently prolongs the survival of filtration surgery, but the subconjunctival use with HHT liposomes or HHT solution at a low dose does not significantly prolong the survival of filtration surgery in rabbits. Significant corneal haze and corneal neovascularization resulted from using HHT at a high dose.. The success rate of rabbit filtration surgery can not be markedly increased by the postoperative use of HHT liposomes or its low dose solution. When the high dosage of HHT solution is used, transient elevation of the success rate can be obtained, however the side-effect is also significantly increased.

Topics: Animals; Dose-Response Relationship, Drug; Female; Filtration; Glaucoma; Harringtonines; Homoharringtonine; Injections; Intraocular Pressure; Liposomes; Male; Rabbits