Intravitreal recombinant tPA before vitrectomy for diabetic tractional retinal detachment: A randomized controlled trial. Issue 6 (November 2022)

• Record Type: Journal Article
• Authors: Falavarjani, Khalil Ghasemi; Anvari, Pasha; Shad, Esrafil; Dehghan Niri, Mohammad Hasan; Sedaghat, Ahad; Abdi, Fatemeh; Parvaresh, Mohammad Mehdi; Saeidian, Behrouz; Gordiz, Arzhang; Amirfarhangi Anbardan, Abdollah
• Is Part Of: European journal of ophthalmology. Volume 32:Issue 6(2022)
• Page Start: 3522
• Page End: 3526
• Publication Date: 2022-11
• Subjects: Diabetic retinopathy -- fibrovascular proliferation -- retinal detachment -- tractional retinal detachment -- tissue plasminogen activator -- vitrectomy; Ophthalmology -- Periodicals; Eye -- Diseases -- Periodicals; 617.7005
• DOI: 10.1177/11206721221116013
• Languages: English
• ISSNs: 1120-6721

Abstract

Purpose: To investigate the effect of intravitreal recombinant tissue plasminogen activator (rt-PA) injection before vitrectomy on surgical facility and outcome in diabetic tractional retinal detachments (TRD). Methods: Prospective, randomized, interventional clinical trial. A total of 38 eyes with diabetic TRD were candidates for vitrectomy. Patients were randomized 1:1 to receive intravitreal rt-PA, five to seven days before vitrectomy or no injection. Intraoperative surgical facility and anatomic success at month 3 after surgery were assessed. Results: Mean patient age was 54.2 ± 9.4 years. There was no statistically significant difference between rt-PA and no injection groups with regard to anatomic success (89% versus 95%, respectively, P = 0.547) and best corrected visual acuity at 3 months (2.0 versus 2.1 logMAR, respectively, P = 0.840). However, surgical facility score was statistically significantly lower in rt-PA injection group compared to no injection group (4.1 ± 1.7, 5.8 ± 2.0, respectively, P = 0.007). Conclusions: Vitrectomy for TRD was easier after preoperative rt-PA injection, without affecting the anatomic and visual outcomes.