Cargando…
The effect of a preoperative subconjuntival injection of dexamethasone on blood–retinal barrier breakdown following scleral buckling retinal detachment surgery: a prospective randomized placebo-controlled double blind clinical trial
BACKGROUND: Blood–retinal barrier breakdown secondary to retinal detachment and retinal detachment repair is a factor in the pathogenesis of proliferative vitreoretinopathy (PVR). We wished to investigate whether an estimated 700 to 1000 ng/ml subretinal dexamethasone concentration at the time of su...
Autores principales: | , , , , , |
---|---|
Formato: | Texto |
Lenguaje: | English |
Publicado: |
Springer-Verlag
2010
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2877815/ https://www.ncbi.nlm.nih.gov/pubmed/20182883 http://dx.doi.org/10.1007/s00417-010-1319-8 |
_version_ | 1782181823501041664 |
---|---|
author | Bali, Ernesto Feron, Eric J. Peperkamp, Ed Veckeneer, Marc Mulder, Paul G. van Meurs, Jan C. |
author_facet | Bali, Ernesto Feron, Eric J. Peperkamp, Ed Veckeneer, Marc Mulder, Paul G. van Meurs, Jan C. |
author_sort | Bali, Ernesto |
collection | PubMed |
description | BACKGROUND: Blood–retinal barrier breakdown secondary to retinal detachment and retinal detachment repair is a factor in the pathogenesis of proliferative vitreoretinopathy (PVR). We wished to investigate whether an estimated 700 to 1000 ng/ml subretinal dexamethasone concentration at the time of surgery would decrease the blood–retinal barrier breakdown postoperatively. METHODS: Prospective, placebo-controlled, double blind clinical trial. In 34 patients with rhegmatogenous retinal detachment scheduled for conventional scleral buckling retinal detachment surgery, a subconjunctival injection of 0.5 ml dexamethasone diphosphate (10 mg) or 0.5 ml placebo was given 5–6 hours before surgery. Differences in laser flare photometry (KOWA) measurements taken 1, 3 and 6 weeks after randomisation between dexamethasone and placebo were analysed using mixed model ANOVA, while correcting for the preoperative flare measurement. RESULTS: Six patients did not complete the study, one because of recurrent detachment within 1 week, and five because they missed their postoperative laser flare visits. The use of dexamethasone resulted in a statistically significant decrease in laser flare measurements at the 1-week postoperative visit. CONCLUSION: The use of a preoperative subconjunctival injection of dexamethasone decreased 1-week postoperative blood–retina barrier breakdown in patients undergoing conventional scleral buckling retinal detachment surgery. This steroid priming could be useful as a part of a peri-operative regime that would aim at decreasing the incidence of PVR. |
format | Text |
id | pubmed-2877815 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | Springer-Verlag |
record_format | MEDLINE/PubMed |
spelling | pubmed-28778152010-06-10 The effect of a preoperative subconjuntival injection of dexamethasone on blood–retinal barrier breakdown following scleral buckling retinal detachment surgery: a prospective randomized placebo-controlled double blind clinical trial Bali, Ernesto Feron, Eric J. Peperkamp, Ed Veckeneer, Marc Mulder, Paul G. van Meurs, Jan C. Graefes Arch Clin Exp Ophthalmol Retinal Disorders BACKGROUND: Blood–retinal barrier breakdown secondary to retinal detachment and retinal detachment repair is a factor in the pathogenesis of proliferative vitreoretinopathy (PVR). We wished to investigate whether an estimated 700 to 1000 ng/ml subretinal dexamethasone concentration at the time of surgery would decrease the blood–retinal barrier breakdown postoperatively. METHODS: Prospective, placebo-controlled, double blind clinical trial. In 34 patients with rhegmatogenous retinal detachment scheduled for conventional scleral buckling retinal detachment surgery, a subconjunctival injection of 0.5 ml dexamethasone diphosphate (10 mg) or 0.5 ml placebo was given 5–6 hours before surgery. Differences in laser flare photometry (KOWA) measurements taken 1, 3 and 6 weeks after randomisation between dexamethasone and placebo were analysed using mixed model ANOVA, while correcting for the preoperative flare measurement. RESULTS: Six patients did not complete the study, one because of recurrent detachment within 1 week, and five because they missed their postoperative laser flare visits. The use of dexamethasone resulted in a statistically significant decrease in laser flare measurements at the 1-week postoperative visit. CONCLUSION: The use of a preoperative subconjunctival injection of dexamethasone decreased 1-week postoperative blood–retina barrier breakdown in patients undergoing conventional scleral buckling retinal detachment surgery. This steroid priming could be useful as a part of a peri-operative regime that would aim at decreasing the incidence of PVR. Springer-Verlag 2010-02-25 2010 /pmc/articles/PMC2877815/ /pubmed/20182883 http://dx.doi.org/10.1007/s00417-010-1319-8 Text en © The Author(s) 2010 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. |
spellingShingle | Retinal Disorders Bali, Ernesto Feron, Eric J. Peperkamp, Ed Veckeneer, Marc Mulder, Paul G. van Meurs, Jan C. The effect of a preoperative subconjuntival injection of dexamethasone on blood–retinal barrier breakdown following scleral buckling retinal detachment surgery: a prospective randomized placebo-controlled double blind clinical trial |
title | The effect of a preoperative subconjuntival injection of dexamethasone on blood–retinal barrier breakdown following scleral buckling retinal detachment surgery: a prospective randomized placebo-controlled double blind clinical trial |
title_full | The effect of a preoperative subconjuntival injection of dexamethasone on blood–retinal barrier breakdown following scleral buckling retinal detachment surgery: a prospective randomized placebo-controlled double blind clinical trial |
title_fullStr | The effect of a preoperative subconjuntival injection of dexamethasone on blood–retinal barrier breakdown following scleral buckling retinal detachment surgery: a prospective randomized placebo-controlled double blind clinical trial |
title_full_unstemmed | The effect of a preoperative subconjuntival injection of dexamethasone on blood–retinal barrier breakdown following scleral buckling retinal detachment surgery: a prospective randomized placebo-controlled double blind clinical trial |
title_short | The effect of a preoperative subconjuntival injection of dexamethasone on blood–retinal barrier breakdown following scleral buckling retinal detachment surgery: a prospective randomized placebo-controlled double blind clinical trial |
title_sort | effect of a preoperative subconjuntival injection of dexamethasone on blood–retinal barrier breakdown following scleral buckling retinal detachment surgery: a prospective randomized placebo-controlled double blind clinical trial |
topic | Retinal Disorders |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2877815/ https://www.ncbi.nlm.nih.gov/pubmed/20182883 http://dx.doi.org/10.1007/s00417-010-1319-8 |
work_keys_str_mv | AT baliernesto theeffectofapreoperativesubconjuntivalinjectionofdexamethasoneonbloodretinalbarrierbreakdownfollowingscleralbucklingretinaldetachmentsurgeryaprospectiverandomizedplacebocontrolleddoubleblindclinicaltrial AT feronericj theeffectofapreoperativesubconjuntivalinjectionofdexamethasoneonbloodretinalbarrierbreakdownfollowingscleralbucklingretinaldetachmentsurgeryaprospectiverandomizedplacebocontrolleddoubleblindclinicaltrial AT peperkamped theeffectofapreoperativesubconjuntivalinjectionofdexamethasoneonbloodretinalbarrierbreakdownfollowingscleralbucklingretinaldetachmentsurgeryaprospectiverandomizedplacebocontrolleddoubleblindclinicaltrial AT veckeneermarc theeffectofapreoperativesubconjuntivalinjectionofdexamethasoneonbloodretinalbarrierbreakdownfollowingscleralbucklingretinaldetachmentsurgeryaprospectiverandomizedplacebocontrolleddoubleblindclinicaltrial AT mulderpaulg theeffectofapreoperativesubconjuntivalinjectionofdexamethasoneonbloodretinalbarrierbreakdownfollowingscleralbucklingretinaldetachmentsurgeryaprospectiverandomizedplacebocontrolleddoubleblindclinicaltrial AT vanmeursjanc theeffectofapreoperativesubconjuntivalinjectionofdexamethasoneonbloodretinalbarrierbreakdownfollowingscleralbucklingretinaldetachmentsurgeryaprospectiverandomizedplacebocontrolleddoubleblindclinicaltrial AT baliernesto effectofapreoperativesubconjuntivalinjectionofdexamethasoneonbloodretinalbarrierbreakdownfollowingscleralbucklingretinaldetachmentsurgeryaprospectiverandomizedplacebocontrolleddoubleblindclinicaltrial AT feronericj effectofapreoperativesubconjuntivalinjectionofdexamethasoneonbloodretinalbarrierbreakdownfollowingscleralbucklingretinaldetachmentsurgeryaprospectiverandomizedplacebocontrolleddoubleblindclinicaltrial AT peperkamped effectofapreoperativesubconjuntivalinjectionofdexamethasoneonbloodretinalbarrierbreakdownfollowingscleralbucklingretinaldetachmentsurgeryaprospectiverandomizedplacebocontrolleddoubleblindclinicaltrial AT veckeneermarc effectofapreoperativesubconjuntivalinjectionofdexamethasoneonbloodretinalbarrierbreakdownfollowingscleralbucklingretinaldetachmentsurgeryaprospectiverandomizedplacebocontrolleddoubleblindclinicaltrial AT mulderpaulg effectofapreoperativesubconjuntivalinjectionofdexamethasoneonbloodretinalbarrierbreakdownfollowingscleralbucklingretinaldetachmentsurgeryaprospectiverandomizedplacebocontrolleddoubleblindclinicaltrial AT vanmeursjanc effectofapreoperativesubconjuntivalinjectionofdexamethasoneonbloodretinalbarrierbreakdownfollowingscleralbucklingretinaldetachmentsurgeryaprospectiverandomizedplacebocontrolleddoubleblindclinicaltrial |