Abstract
Background
Cellophane membranes are an early stage of proliferative vitreoretinopathy (PVR) complicating retinal detachment surgery. Our aim was to assess whether a prolonged administration of systemic corticosteroids would attenuate early stages of PVR such as cellophane membranes.
Design
Prospective randomized placebo-controlled double-blind clinical trial.
Patients and methods
A total of 220 consecutive eyes (220 patients) were operated for primary rhegmatogenous retinal detachment (RD), mainly by scleral buckling procedures. Patients were randomized into two groups: 110 patients (steroid group) received prednisone for 15 days starting with 100 mg at the day of surgery and being tapered to 12.5 mg. The control group of 110 patients received placebo in a comparable manner. Follow-up examinations were performed at 1, 3 and 6 months postoperatively, and included visual acuity and assessment of retinal findings.
Results
Cellophane membranes occurred in 41.8%, 46.9%, and 39.1% in the placebo group and 26.7%, 23.6%, and 19.8% in the steroid group at 1, 3 and 6 months postoperatively (p < 0.05, = 0.0005, and <0.005 respectively). The application of five or more cryocoagulation spots was associated with more cases developing cellophane membranes in the placebo than the steroid group (p < 0.05). A complete reattachment of the retina was achieved in 95% steroid and 89% placebo group eyes, and a reattachment of the macula in 98% of both groups. There was no significant difference of the final visual outcome in both groups.
Conclusion
Early stages of PVR such as cellophane membranes after retinal detachment surgery can be reduced with corticosteroids in oral doses.
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Acknowledgement
The authors would like to express their gratitude to the late Professor Robert Machemer, M.D., and Ulrich Steinhorst, M.D., Department of Ophthalmology, Durham NC, for their substantial support in planning, discussing and designing this study during the years 1993 through 1999.
No funding was received to support this study.
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Data for this study were collected from patients at the Department of Ophthalmology, University of Bern, Switzerland; former Director F. Koerner.
The study was conducted in accordance with the Declaration of Helsinki and its subsequent amendments, Good Clinical Practice, and applicable regulatory requirements. The study was approved by the local institutional ethics committee, and all participants gave written informed consent prior to entry into the study.
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Koerner, F., Koerner-Stiefbold, U. & Garweg, J.G. Systemic corticosteroids reduce the risk of cellophane membranes after retinal detachment surgery: a prospective randomized placebo-controlled double-blind clinical trial. Graefes Arch Clin Exp Ophthalmol 250, 981–987 (2012). https://doi.org/10.1007/s00417-011-1919-y
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DOI: https://doi.org/10.1007/s00417-011-1919-y