VITRECTOMY AND COMPLETE DRAINAGE OF SUPRACHOROIDAL FLUID WITHOUT PERIOPERATIVE STEROIDS FOR RHEGMATOGENOUS RETINAL DETACHMENT COMBINED WITH CHOROIDAL DETACHMENT: A Randomized Clinical Trial.

PURPOSE

To investigate the surgical effect of complete drainage of suprachoroidal fluid before vitrectomy to avoid perioperative steroids in rhegmatogenous retinal detachment combined with choroidal detachment eyes.

METHODS

It was a prospective, randomized controlled trial. Fifty-eight eyes were randomly divided into the no steroids (NS) group and local steroids (LS) group, 29 eyes each, respectively. Patients in the LS group received a single preoperative periocular injection of methylprednisolone, while suprachoroidal fluid drainage was performed before vitrectomy in eyes of the NS group. Follow-up assessments were performed at 1 week, 1 month, 3 months, and 6 months postoperatively.

RESULTS

The postoperative retinal reattachment rate was similar in the NS and LS groups (96.6% vs. 93.1%, P = 1.00). Best-corrected visual acuity was improved in 72.4% and 75.9% in the NS and LS groups, respectively. Inflammation occurred in five eyes (17.2%) in the NS group and six eyes (20.7%) in the LS group ( P = 0.74). Hypotony occurred in 11 (37.9%) and 14 eyes (48.3%) in the LS and NS groups ( P = 0.43), respectively. Macular chorioretinal folds were found in 21 (72.4%) and 22 eyes (75.9%) in the LS and NS groups ( P = 0.76), respectively. Hypotony and chorioretinal folds disappeared after 1 week postoperatively.

CONCLUSION

Preoperative steroids may not be necessary for rhegmatogenous retinal detachment combined with choroidal detachment patients if the suprachoroidal fluid is completely drained before vitrectomy. Postoperative retinal reattachment does not depend on the use of preoperative steroids; instead, surgeons should focus on improving surgical techniques in rhegmatogenous retinal detachment combined with choroidal detachment to improve the retinal reattachment rate.