Postoperative retinal fibrosis--a controlled clinical study of systemic steroid therapy

In a prospective clinical trial, the effect of systemic steroids on the incidence and severity of retinal fibrosis following retinal detachment surgery was tested against placebo. Several grades of retinal fibrosis of various degrees of severity were defined prior to the study. The maximum postoperative incidence of eyes with any signs of retinal fibrosis was 65% (75.4% in the placebo group, 63.3% in the steroid group). A set of fibrosis criteria was identified that had a tendency to respond to systemic steroids with a statistical significance increasing with time. The majority of these steroid-responsive criteria was of a mild degree and located at the posterior pole. The mean visual acuity was significantly lower in eyes with retinal fibrosis. The effect of systemic steroids on retinal fibrosis tested under clinical conditions was considerably weaker than that known from experimental conditions with intravitreal injections of triamcinolone acetonide.