Steroids as an adjunct for reducing the incidence of proliferative vitreoretinopathy after rhegmatogenous retinal detachment surgery: a systematic review and meta-analysis

Abstract

BackgroundThis meta-analysis was performed to determine the effectiveness of steroids as an adjunct following rhegmatogenous retinal detachment (RRD) surgery.MethodsRRD patients with or without proliferative vitreoretinopathy (PVR) were included. The treatment group included patients in whom steroids were used as an adjunct and a control group in which placebo was used. Only randomized controlled trials were included. We searched the main electronic databases and included studies published until July 2014. PVR odds ratio, visual acuity, retinal reattachment rate, and complications were evaluated in three trials.ResultsThree randomized controlled trials were included in the meta-analysis. There was no significant difference in the incidence of postoperative PVR between groups (heterogeneity I2=48%, P=0.14). However, the incidence of postoperative PVR was lower in the treatment group (I2=0%, P<0.0001) than in the control group when a PVR grade C study was excluded. There was no statistically significant difference in postoperative visual acuity between the treatment and control groups (odds ratio −0.18; 95% confidence interval −0.38, 0.02; P=0.08). The two groups had similar results for primary/final retinal reattachment and reoperation rate. There was no significant difference in postoperative intraocular pressure.ConclusionThis systematic review demonstrates that steroids may significantly reduce the incidence of postoperative PVR grade B or lower following RRD surgery.

The importance of pegaptanib sodium treatment for patients with vascular active vitreoretinopathy

“…Researches have showed that retinal detachment with avascularity of the peripheral retina typically is associated with familial exudative vitreoretinopathy, which can cause by mutations of KIF11 and lead to microcephaly, lymphedema, chorioretinal dysplasia, microcephaly, chorioretinal dysplasia and mental retardation ( 4 ). Currently, surgeries and drug treatments are efficient way to cure vitreoretinopathy, while vascular active vitreoretinopathy (VAVR) frequently remains one of the most severe complications of rhegmatogenous retinal detachment (RD) with an incidence of 5–11% ( 5 ). VAVR also presents one of the most frequent causes of surgical failure for patients with VAVR ( 6 ).…”