Toxicity of intraocular daunomycin.

Due to its antiproliferative properties, daunomycin is of potential use in the treatment of proliferative vitreoretinopathy and capsular fibrosis after cataract extraction. Previous biomicroscopic, electrophysiologic and histologic studies in the rabbit had shown that higher drug doses caused damage to all ocular structures after exposure to daunomycin. Based on the animal studies, we concluded that there is a small but usable therapeutic window for this drug. As electrophysiology and histology are not readily available for the examination of the human silicone-filled eye, we used clinical examination and fluorescein angiography as toxicity parameters. The comparison of the visual acuity and the central visual field showed that visual acuity is a reliable parameter of retinal and macular function after vitreoretinal surgery. Any specific toxicity attributable to daunomycin could not be observed in our patients. We conclude that the daunomycin perfusion (7.5 mg/l for 10 min.) is well tolerated by the human eye.