Primary vitrectomy for combined rhegmatogenous retinal detachment and choroidal detachment with or without oral corticosteroids: a pilot study.
OBJECTIVE
The occurrence of choroidal detachment (CD) in eyes with primary rhegmatogenous retinal detachment (RRD) is relatively uncommon (2%-4.5%). Recent reports suggest that primary vitrectomy yields better anatomic success than scleral buckling. However, for these inflamed eyes with low intraocular pressure, the influence of preoperative oral steroids on reattachment rates has not been elucidated yet.


METHODS
Twenty eyes with combined RRD and CD that underwent primary vitrectomy were randomized to receive oral steroids (for 1 week) or no oral steroids before surgery.


RESULTS
Preoperative clinical data such as mean age, lens status, Snellen visual acuity, duration of macular detachment, CD (size and extent), and retinal detachment characteristics (e.g., extent, number of retinal breaks, atrophic or tractional retinal break, size of retinal break, and location of retinal break) were similarly distributed in both groups. Single-operation anatomic success was 81.8% (9/11) among those patients who received preoperative oral steroids and was 66.7% (6/9) among those who did not receive preoperative oral steroids. After reoperation, anatomic success was 100% in both groups. The mean follow-up was 20.1 months.


CONCLUSIONS
The results suggest that administration of oral steroids before primary vitrectomy in eyes with combined RRD and CD improves reattachment rates.
Sharma
Tarun
T
Department of Vitreoretinal Service, Sankara Nethralaya, Vision Research Foundation, Tamil Nadu, India. drts@sankaranethralaya.org
Gopal
Lingam
L
Reddy
Rajeev K
RK
Kasinathan
N
N
Shah
Nitant A
NA
Sulochana
K N
KN
Miriam
Karunakaran Coral
KC
Arvind
K
K
Ramakrishnan
S
S
Sukumar
B
B
D000284:Administration, Oral; D015862:Choroid Diseases / Q000150:complications / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D004322:Drainage / Q000379:methods; D005260:Female; D005466:Fluorocarbons / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011239:Prednisolone / Q000627:therapeutic use*; D011446:Prospective Studies; D012163:Retinal Detachment / Q000150:complications / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D013459:Sulfur Hexafluoride / Q000627:therapeutic use; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy
D005466:Fluorocarbons; D005938:Glucocorticoids; D011239:Prednisolone; C042852:perflutren; D013459:Sulfur Hexafluoride