S Fekrat1, E de Juan, P A Campochiaro. 1. Wilmer Ophthalmological Institute, Johns Hopkins Medical Institutions, Baltimore, MD 21287-9277.
Abstract
PURPOSE: To determine if postoperative oral 13-cis-retinoic acid alters the rate of recurrent retinal detachment in eyes undergoing surgery for proliferative vitreoretinopathy (PVR). METHODS:Twenty eyes of 20 adult patients with a detachment due to PVR were identified after retrospective review of the patient records of a single vitreoretinal surgeon (EdJ) over an 18-month period (January 1992-August 1993). All 20 eyes underwent surgical repair using similar techniques. Ten patients received 40 mg oral 13-cis-retinoic acid twice daily for 4 weeks postoperatively (study group). The remaining ten patients did not (control group). The main outcome measure was retinal attachment or detachment. RESULTS: No statistically significant differences in preoperative patient characteristics or surgical procedure were present between the groups. Nine of ten eyes in the study group remained attached during a mean follow-up of 8.3 months, whereas four of ten eyes in the control group remained attached (P = 0.061) during a mean follow-up of 9.6 months. The rate of macular pucker was similar between the groups. The one eye in the study group that redetached did not have PVR. Of the six eyes in the control group that detached, four had 6 or more clock hours of PVR. The final visual acuity was better than 20/400 in six study eyes and four control eyes. CONCLUSIONS: Despite the small sample size and retrospective nature, the postoperative administration of oral 13-cis-retinoic acid appears to decrease proliferative vitreoretinopathy and increase the rate of retinal attachment after surgical repair. A prospective, randomized, controlled clinical trial is warranted.
RCT Entities:
PURPOSE: To determine if postoperative oral 13-cis-retinoic acid alters the rate of recurrent retinal detachment in eyes undergoing surgery for proliferative vitreoretinopathy (PVR). METHODS: Twenty eyes of 20 adult patients with a detachment due to PVR were identified after retrospective review of the patient records of a single vitreoretinal surgeon (EdJ) over an 18-month period (January 1992-August 1993). All 20 eyes underwent surgical repair using similar techniques. Ten patients received 40 mg oral 13-cis-retinoic acid twice daily for 4 weeks postoperatively (study group). The remaining ten patients did not (control group). The main outcome measure was retinal attachment or detachment. RESULTS: No statistically significant differences in preoperative patient characteristics or surgical procedure were present between the groups. Nine of ten eyes in the study group remained attached during a mean follow-up of 8.3 months, whereas four of ten eyes in the control group remained attached (P = 0.061) during a mean follow-up of 9.6 months. The rate of macular pucker was similar between the groups. The one eye in the study group that redetached did not have PVR. Of the six eyes in the control group that detached, four had 6 or more clock hours of PVR. The final visual acuity was better than 20/400 in six study eyes and four control eyes. CONCLUSIONS: Despite the small sample size and retrospective nature, the postoperative administration of oral 13-cis-retinoic acid appears to decrease proliferative vitreoretinopathy and increase the rate of retinal attachment after surgical repair. A prospective, randomized, controlled clinical trial is warranted.
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