The Effect of Statins on the Prevention of Proliferative Vitreoretinopathy (PVR) Following Vitrectomy or Scleral Buckling for Rhegmatogenous Retinal Detachment (RRD): A Pilot Randomized Controlled Trial
Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine
Purpose To investigate the possible effect of statin in preventing proliferative vitreoretinopathy (PVR) after successful repair of rhegmatogenous retinal detachment (RRD) by either vitrectomy or scleral buckling. Patients and Methods 103 patients with RRD were included in this randomized controlled trial. After successful repair of RRD, patients were randomly assigned into two groups. One group received statin (Atorvastatin 40 mg daily for 3 months) while the other group stayed untreated. Regular follow-up examinations were conducted up to 6 months after surgery. Results PVR occurred in 3.8% of patients in the statin group compared to 22% in the untreated group (p=0.005). In the subgroup analysis, a significantly lower rate of PVR was observed in the statin group exclusively among patients who underwent vitrectomy with silicone oil tamponade (p=0.010), while no significant difference was detected in those who underwent scleral buckling (p=0.217). Other variables including gender, smoking, alcohol consumption, diabetes, hypertension, tear size, tear location and lens status had no statistically significant impact on occurrence of PVR. There was no statistically significant difference regarding age, duration of symptoms before surgery, intraocular pressure, visual acuity before surgery, choroidal thickness before and after surgery and the number of tears between patients with and without PVR. Post-op visual acuity was significantly worse in patients who developed PVR (p-value
Abstract
Purpose To investigate the possible effect of statin in preventing proliferative vitreoretinopathy (PVR) after successful repair of rhegmatogenous retinal detachment (RRD) by either vitrectomy or scleral buckling. Patients and Methods 103 patients with RRD were included in this randomized controlled trial. After successful repair of RRD, patients were randomly assigned into two groups. One group received statin (Atorvastatin 40 mg daily for 3 months) while the other group stayed untreated. Regular follow-up examinations were conducted up to 6 months after surgery. Results PVR occurred in 3.8% of patients in the statin group compared to 22% in the untreated group (p=0.005). In the subgroup analysis, a significantly lower rate of PVR was observed in the statin group exclusively among patients who underwent vitrectomy with silicone oil tamponade (p=0.010), while no significant difference was detected in those who underwent scleral buckling (p=0.217). Other variables including gender, smoking, alcohol consumption, diabetes, hypertension, tear size, tear location and lens status had no statistically significant impact on occurrence of PVR. There was no statistically significant difference regarding age, duration of symptoms before surgery, intraocular pressure, visual acuity before surgery, choroidal thickness before and after surgery and the number of tears between patients with and without PVR. Post-op visual acuity was significantly worse in patients who developed PVR (p-value < 0.001). Conclusion In this study, post operative use of Atorvastatin 40 mg daily for 3 months was associated with significantly lower rate of PVR formation during 6 months follow up after successful repair of RRD, particularly in patients who underwent pars plana vitrectomy with silicone oil tamponade. No statistically significant effect was observed in the scleral buckling subgroup.