Fekrat S, de Juan E, Campochiaro P A
Wilmer Ophthalmological Institute, Johns Hopkins Medical Institutions, Baltimore, MD 21287-9277.
Ophthalmology. 1995 Mar;102(3):412-8. doi: 10.1016/s0161-6420(95)31007-x.
To determine if postoperative oral 13-cis-retinoic acid alters the rate of recurrent retinal detachment in eyes undergoing surgery for proliferative vitreoretinopathy (PVR).
Twenty eyes of 20 adult patients with a detachment due to PVR were identified after retrospective review of the patient records of a single vitreoretinal surgeon (EdJ) over an 18-month period (January 1992-August 1993). All 20 eyes underwent surgical repair using similar techniques. Ten patients received 40 mg oral 13-cis-retinoic acid twice daily for 4 weeks postoperatively (study group). The remaining ten patients did not (control group). The main outcome measure was retinal attachment or detachment.
No statistically significant differences in preoperative patient characteristics or surgical procedure were present between the groups. Nine of ten eyes in the study group remained attached during a mean follow-up of 8.3 months, whereas four of ten eyes in the control group remained attached (P = 0.061) during a mean follow-up of 9.6 months. The rate of macular pucker was similar between the groups. The one eye in the study group that redetached did not have PVR. Of the six eyes in the control group that detached, four had 6 or more clock hours of PVR. The final visual acuity was better than 20/400 in six study eyes and four control eyes.
Despite the small sample size and retrospective nature, the postoperative administration of oral 13-cis-retinoic acid appears to decrease proliferative vitreoretinopathy and increase the rate of retinal attachment after surgical repair. A prospective, randomized, controlled clinical trial is warranted.
确定术后口服13 - 顺式视黄酸是否会改变增生性玻璃体视网膜病变（PVR）手术患者视网膜脱离复发率。
在回顾性查阅一位玻璃体视网膜外科医生（EdJ）18个月（1992年1月至1993年8月）的患者记录后，确定了20例因PVR导致视网膜脱离的成年患者的20只眼。所有20只眼均采用相似技术进行手术修复。10例患者术后每天两次口服40mg 13 - 顺式视黄酸，持续4周（研究组）。其余10例患者未服用（对照组）。主要观察指标为视网膜附着或脱离情况。
两组患者术前特征或手术操作无统计学显著差异。研究组10只眼中有9只在平均8.3个月的随访期内保持视网膜附着，而对照组10只眼中有4只在平均9.6个月的随访期内保持视网膜附着（P = 0.061）。两组黄斑皱缩发生率相似。研究组中1只再次发生视网膜脱离的眼不存在PVR。对照组6只发生视网膜脱离的眼中，4只存在6个或更多钟点范围的PVR。6只研究组眼和4只对照组眼的最终视力优于20/400。
尽管样本量小且为回顾性研究，但术后口服13 - 顺式视黄酸似乎可减少增生性玻璃体视网膜病变，并提高手术修复后视网膜附着率。有必要进行一项前瞻性、随机、对照临床试验。
