The effect of preoperative subconjuntival injection of dexamethasone on the blood–retinal barrier breakdown (BRB) following conventional rhegmatogenous retinal detachment (RRD)surgery.

Abstract

Abstract: : Purpose:To evaluate the effect of subconjunctival injection of dexamethasone prior to scleral buckling (SB) surgery on the postoperative breakdown of the blood–retina barrier (BRB), a risk factor for the development of proliferative vitreoretinpathy (PVR). Methods: Design: A prospective, randomised, placebo–controlled study. Patients admitted at The Rotterdam Eye Hospital with RRD undergoing SB were eligible for the study. Examination included: EDTRS Visual Acuity (VA), laser flare measurement, biomicroscopy and fundus examination preop. and 1, 3, 6 weeks postop.. Patients received a subconjunctival injection 0.5cc NaCl or 0.5cc Dexamethasone diphosfate 20 mg/ml. 3 to 4 6 hours before SB.. We used an Ancova test for statistical analysis. Results:36 patients were included; 15 patients were in the placebo group and 13 in the Dexamethasone group. 4 patients had a re–detachment in the six week. There was no difference in VA between the two groups at any time point of the follow up. Laser Flare, however was statistically significant (P=0.031) reduced after 1 week in the dexamethasone group. Conclusions:Priming with a subconjunctival injection of Dexamethasone diphosfate 20 mg/ml was effective in reducing surgical induced BRB breakdown which may be of help in reducing the risk of PVR.

Keywords: retinal detachment • retina