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Intravitreal recombinant tPA before vitrectomy for diabetic tractional retinal detachment: A randomized controlled
Khalil Ghasemi Falavarjani1,2, Pasha Anvari1, Esrafil Shad1
1Eye Research Center, The Five Senses Health Institute, 440827Iran University of Medical Sciences, Tehran, Iran.
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.
