Intravitreal recombinant tPA before vitrectomy for diabetic tractional retinal detachment: a randomized controlled trial
Khalil Ghasemi Falavarjani1 , Pasha Anvari1 *, Esrafil Shad2 , Mohammad Hasan Dehghan Niri1 , Ahad Sedaghat1 , Fatemeh Abdi 1 , Mohammad Mehdi Parvaresh1 , Behrouz Saeidian1 , Arzhang Gordiz1 , Abdollah Amirfarhangi Anbardan 3
- Eye Research Center, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran
- Eye Research Center, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran.
- Department of Cardiovascular Disease, Hazrat‐e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran
Abstract: 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 who 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
Conclusion: Vitrectomy for TRD was easier after preoperative rt-PA injection, without affecting the anatomic and visual outcomes
