THE EFFECT OF ORAL 13-CIS-RETINOIC ACID ON RETINAL REDETACHMENT AFTERSURGICAL REPAIR IN EYES WITH PROLIFERATIVE VITREORETINOPATHY

Purpose: To determine if postoperative oral 13-cis-retinoic acid alter s 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 retr ospective review of the patient records of a single vitreoretinal surg eon (EdJ) over an 18-month period (January 1992-August 1993). All 20 e yes underwent surgical repair using similar techniques. Ten patients r eceived 40 mg oral 13-cis-retinoic acid twice daily for 4 weeks postop eratively (study group). The remaining ten patients did not (control g roup). The main outcome measure was retinal attachment or detachment. Results: No statistically significant differences in preoperative pati ent characteristics or surgical procedure were present between the gro ups. Nine of ten eyes in the study group remained attached during a me an follow-up of 8.3 months, whereas four of ten eyes in the control gr oup remained attached (P = 0.061) during a mean follow-up of 9.6 month s. 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 ey es 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 ey es and four control eyes. Conclusions: Despite the small sample size a nd retrospective nature, the postoperative administration of oral 13-c is-retinoic acid appears to decrease proliferative vitreoretinopathy a nd increase the rate of retinal attachment after surgical repair. A pr ospective, randomized, controlled clinical trial is warranted.