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Non-surgical interventions for proliferative vitreoretinopathy-a systematic review
Guy Hunter1, Nairn Maclean2, Stephanie Watson3
1Institute of Naval Medicine, Gosport, UK. guy.hunter@nhs.net.
Eye (London, England)
|May 28, 2025
Summary
Non-surgical treatments for proliferative vitreoretinopathy (PVR) after retinal detachment (RD) repair are being investigated. Current evidence shows no clinically significant benefits, highlighting the need for further research into PVR pathobiology and interventions.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Vitreoretinal Diseases
Background:
- Proliferative vitreoretinopathy (PVR) is a primary cause of surgical failure in retinal detachment (RD) repair.
- PVR complicates up to 10% of spontaneous RD and 50% of open globe injury-related RD.
- Effective non-surgical interventions are needed to reduce PVR incidence and severity, especially with limited surgical access.
Approach:
- Systematic review of randomized controlled trials (RCTs) for non-surgical interventions to prevent or treat PVR.
- Searched PubMed, Clinicaltrials.gov, Medline, and CINAHL up to November 2024.
- Assessed Risk of Bias (RoB) using the Cochrane RoB2 tool for 27 included studies.
Key Points:
- 1981 patients in primary prevention studies and 1394 in treatment studies were analyzed.
- Some agents showed individual improvements, but results lacked replication in larger studies.
- Concerns regarding Risk of Bias were noted across multiple studies.
Conclusions:
- No non-surgical interventions for PVR after RD repair and trauma have demonstrated clinically significant, repeatable benefits to date.
- Further research into PVR pathobiology is crucial.
- Larger prospective studies of existing preventative strategies may pave the way for novel interventions.
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