Skip to main content
Erschienen in: International Ophthalmology 1/2024

01.12.2024 | Original Paper

The effect of adjuvant Mitomycin C during vitrectomy on functional and anatomical outcomes in patients with severe diabetic tractional retinal detachment

verfasst von: Ihsan Gokhan Gurelik, Huseyin Baran Ozdemir, Burak Acar

Erschienen in: International Ophthalmology | Ausgabe 1/2024

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To evaluate the effect of adjuvant Mitomycin C (MMC) use on the anatomical and functional success of vitreoretinal surgery (VRS) in severe diabetic tractional retinal detachment (dTRD) patients.

Methods

A retrospective analysis of consecutive patients undergoing VRS due to severe dTRD was conducted. Patients were categorized into those who received 20 µg/0.1 mL MMC via MMC sandwich method (Group 1) and those who did not (Group 2). Demographics, surgical characteristics, visual outcomes, and complications that may related to MMC were analyzed.

Results

A total of 25 eyes were included, 13 in Group 1 and 12 in Group 2. No statistical difference was observed in baseline characteristics between the groups. The mean best-corrected visual acuity was 1.90 ± 0.43 logMAR and 1.93 ± 0.41 logMAR preoperatively and 1.60 ± 0.78 logMAR and 1.56 ± 0.78 logMAR postoperatively in Groups 1 and 2, respectively (p = 0.154). The postoperative mean intraocular pressure was 16.23 ± 2.55 mmHg and 13.08 ± 4.94 mmHg in Groups 1 and 2, respectively (p = 0.225). The rate of re-surgery was significantly lower in Group 1 (0% vs. 41.7% in Group 2, p = 0.015). Retina was attached in all patients at the last visit. No MMC-related complication was recorded.

Conclusion

Intraoperative adjuvant MMC application for severe dTRD significantly reduces re-surgery rates with good anatomical and functional outcomes safely.
Literatur
1.
Zurück zum Zitat The Diabetic Retinopathy Vitrectomy Study Research Group (1988) Early vitrectomy for severe proliferative diabetic retinopathy in eyes with useful vision; clinical application of results of a randomized trial:diabetic retinopathy vitrectomy study report 4. Ophthalmology 95(10):1321–1334. https://doi.org/10.1016/s0161-6420(88)33014-9CrossRef The Diabetic Retinopathy Vitrectomy Study Research Group (1988) Early vitrectomy for severe proliferative diabetic retinopathy in eyes with useful vision; clinical application of results of a randomized trial:diabetic retinopathy vitrectomy study report 4. Ophthalmology 95(10):1321–1334. https://​doi.​org/​10.​1016/​s0161-6420(88)33014-9CrossRef
2.
Zurück zum Zitat La Heij EC, Tecim S, Kessels AG, Liem AT, Japing WJ, Hendrikse F (2004) Clinical variables and their relation to visual outcome after vitrectomy in eyes with diabetic retinal traction detachment. Graefes Arch Clin Exp Ophthalmol 242:210–217CrossRefPubMed La Heij EC, Tecim S, Kessels AG, Liem AT, Japing WJ, Hendrikse F (2004) Clinical variables and their relation to visual outcome after vitrectomy in eyes with diabetic retinal traction detachment. Graefes Arch Clin Exp Ophthalmol 242:210–217CrossRefPubMed
3.
Zurück zum Zitat Meleth AD, Carvounis PE (2014) Outcomes of vitrectomy for tractional retinal detachment in diabetic retinopathy. Int Ophthalmol Clin 54(2):127–139CrossRefPubMed Meleth AD, Carvounis PE (2014) Outcomes of vitrectomy for tractional retinal detachment in diabetic retinopathy. Int Ophthalmol Clin 54(2):127–139CrossRefPubMed
10.
Zurück zum Zitat Iglicki M, Zur D, Fung A, Gabrielle P-H, Lupidi M, Santos R et al (2019) Tractional diabetic retinal detachment surgery with co-adjuvant intravitreal dexamethasone implant: the tradition study. Acta Diabetol 56:1141–1147CrossRefPubMed Iglicki M, Zur D, Fung A, Gabrielle P-H, Lupidi M, Santos R et al (2019) Tractional diabetic retinal detachment surgery with co-adjuvant intravitreal dexamethasone implant: the tradition study. Acta Diabetol 56:1141–1147CrossRefPubMed
11.
Zurück zum Zitat Pratt WB (1994) The anticancer drugs. Oxford University Press, USA Pratt WB (1994) The anticancer drugs. Oxford University Press, USA
12.
Zurück zum Zitat Crowston JG, Akbar AN, Constable PH, Occleston NL, Daniels JT, Khaw PT (1998) Antimetabolite-induced apoptosis in Tenon’s capsule fibroblasts. Investig Ophthalmol Vis Sci 39(2):449–454 Crowston JG, Akbar AN, Constable PH, Occleston NL, Daniels JT, Khaw PT (1998) Antimetabolite-induced apoptosis in Tenon’s capsule fibroblasts. Investig Ophthalmol Vis Sci 39(2):449–454
14.
Zurück zum Zitat Assi A, Khoueir Z, Helou C, Fakhoury H, Cherfan G (2019) Intraocular application of Mitomycin C to prevent proliferative vitreoretinopathy in perforating and severe intraocular foreign body injuries. Eye 33(8):1261–1270CrossRefPubMedPubMedCentral Assi A, Khoueir Z, Helou C, Fakhoury H, Cherfan G (2019) Intraocular application of Mitomycin C to prevent proliferative vitreoretinopathy in perforating and severe intraocular foreign body injuries. Eye 33(8):1261–1270CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Gürelik G, Sül S, Üçgül AY (2021) Intraocular Mitomycin C use in the treatment and prophylaxis of proliferative vitreoretinopathy in severe traumatic retinal detachments. Eur J Ophthalmol 31(6):3284–3293CrossRefPubMed Gürelik G, Sül S, Üçgül AY (2021) Intraocular Mitomycin C use in the treatment and prophylaxis of proliferative vitreoretinopathy in severe traumatic retinal detachments. Eur J Ophthalmol 31(6):3284–3293CrossRefPubMed
17.
18.
Zurück zum Zitat Pastor JC, Rojas J, Pastor-Idoate S, Di Lauro S, Gonzalez-Buendia L, Delgado-Tirado S (2016) Proliferative vitreoretinopathy: a new concept of disease pathogenesis and practical consequences. Prog Retin Eye Res 51:125–155CrossRefPubMed Pastor JC, Rojas J, Pastor-Idoate S, Di Lauro S, Gonzalez-Buendia L, Delgado-Tirado S (2016) Proliferative vitreoretinopathy: a new concept of disease pathogenesis and practical consequences. Prog Retin Eye Res 51:125–155CrossRefPubMed
21.
Zurück zum Zitat Iyer SSR, Lagrew MK, Tillit SM, Roohipourmoallai R, Korntner S (2021) The vitreous ecosystem in diabetic retinopathy: insight into the patho-mechanisms of disease. Int J Mol Sci 22(13):7142CrossRefPubMedPubMedCentral Iyer SSR, Lagrew MK, Tillit SM, Roohipourmoallai R, Korntner S (2021) The vitreous ecosystem in diabetic retinopathy: insight into the patho-mechanisms of disease. Int J Mol Sci 22(13):7142CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Zhou J, Wang S, Xia X (2012) Role of intravitreal inflammatory cytokines and angiogenic factors in proliferative diabetic retinopathy. Curr Eye Res 37(5):416–420CrossRefPubMed Zhou J, Wang S, Xia X (2012) Role of intravitreal inflammatory cytokines and angiogenic factors in proliferative diabetic retinopathy. Curr Eye Res 37(5):416–420CrossRefPubMed
28.
Zurück zum Zitat Jonas J, Söfker A, Degenring R (2003) Intravitreal triamcinolone acetonide as an additional tool in pars plana vitrectomy for proliferative diabetic retinopathy. Eur J Ophthalmol 13(5):468–473CrossRefPubMed Jonas J, Söfker A, Degenring R (2003) Intravitreal triamcinolone acetonide as an additional tool in pars plana vitrectomy for proliferative diabetic retinopathy. Eur J Ophthalmol 13(5):468–473CrossRefPubMed
29.
Zurück zum Zitat Chan ES, Cronstein BN (2002) Molecular action of methotrexate in inflammatory diseases. Arthritis Res Ther 4(4):1–8 Chan ES, Cronstein BN (2002) Molecular action of methotrexate in inflammatory diseases. Arthritis Res Ther 4(4):1–8
Metadaten
Titel
The effect of adjuvant Mitomycin C during vitrectomy on functional and anatomical outcomes in patients with severe diabetic tractional retinal detachment
verfasst von
Ihsan Gokhan Gurelik
Huseyin Baran Ozdemir
Burak Acar
Publikationsdatum
01.12.2024
Verlag
Springer Netherlands
Erschienen in
International Ophthalmology / Ausgabe 1/2024
Print ISSN: 0165-5701
Elektronische ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-024-03152-3

Weitere Artikel der Ausgabe 1/2024

International Ophthalmology 1/2024 Zur Ausgabe

Neu im Fachgebiet Augenheilkunde

Metastase in der periokulären Region

Metastasen Leitthema

Orbitale und periokuläre metastatische Tumoren galten früher als sehr selten. Aber mit der ständigen Aktualisierung von Medikamenten und Nachweismethoden für die Krebsbehandlung werden neue Chemotherapien und Strahlenbehandlungen eingesetzt. Die …

Staging und Systemtherapie bei okulären und periokulären Metastasen

Metastasen Leitthema

Metastasen bösartiger Erkrankungen sind die häufigsten Tumoren, die im Auge diagnostiziert werden. Sie treten bei ungefähr 5–10 % der Patienten mit soliden Tumoren im Verlauf der Erkrankung auf. Besonders häufig sind diese beim Mammakarzinom und …

Wundheilung nach Trabekulektomie

Trabekulektomie CME-Artikel

Die überschießende Wundheilung in der filtrierenden Glaukomchirurgie ist ein zentraler Faktor für ein operatives Versagen. Nach der Einführung der Trabekulektomie in den 1960er-Jahren wurden viele Faktoren erkannt, die mit einer vermehrten …

„standard operating procedures“ (SOP) – Vorschlag zum therapeutischen Management bei periokulären sowie intraokulären Metastasen

Metastasen Leitthema

Peri- sowie intraokuläre Metastasen sind insgesamt gesehen selten und meist Zeichen einer fortgeschrittenen primären Tumorerkrankung. Die Therapie ist daher zumeist palliativ und selten kurativ. Zudem ist die Therapiefindung sehr individuell. Die …

Update Augenheilkunde

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.