Steroids as an adjunct for reducing the incidence of proliferative vitreoretinopathy after rhegmatogenous retinal detachment surgery: a systematic review and meta-analysis

Figures & data

Figure 1 Search strategy flow diagram for PVR and steroids.

Abbreviations: RCT, randomized controlled clinical trial; PVR, proliferative vitreoretinopathy.

Table 1 Patient characteristics in the included trials

Reference	Inclusion criteria	Treatment	Method	n	Age, years (mean ± SD)	Sex (M/F)	VA, logMAR (mean ± SD)		Follow-up	Outcomes
							Before	After
Dehghan et al^Citation25	RRD with PVR grade A or B	Oral prednisolone	1 mg/kg for 10 days	25	48±14	17/8	1.47+0.81	0.62±0.39	6 months	VA; postoperative PVR
		Vitamin B6	Control group	27	42±17	17/10	1.44+0.82	0.78±0.58
Koerner et al^Citation28	RRD with PVR grade A or B	Oral prednisolone	100 mg for 6 days, tapered to 50 mg for 5 days, and 12.5 mg for another 4 days	110	54.5±13.8	68/42	0.36*	0.2*	6 months	VA; postoperative PVR; primary reattachment rate; final reattachment rate; reoperation rate
		Placebo	Control group	110	54.1 + 14.4	76/34	0.43*	0.21*
Ahmadieh et al^Citation30	RRD with PVR grade C	Triamcinolone acetonide	4 mg/0.1 mL injected into silicone-filled vitreous cavity at end of surgery	38	54.5±18.8	30/8	2.1±0.7	1.2+0.7	6 months	VA; postoperative PVR; primary reattachment rate; final reattachment rate; reoperation rate; IOP increase
		Placebo	Control group	37	45.7±20.7	29/8	2.4±0.6	1.4±0.6

Notes: VA logMAR = logl0(1/VA).

* represents mean value.

Abbreviations: RRD, rhegmatogenous retinal detachment; PVR, proliferative vitreoretinopathy; IOP, intraocular pressure; VA, visual acuity; logMAR, logarithm of the minimum angle of resolution; SD, standard deviation; M, male; F, female.

Figure 2 Methodological quality summary. Authors’ judgments about each methodological quality item for each included study.

Notes: + represents yes; - represents no.

Figure 3 Forest plot of the postoperative PVR incidence rate.

Note: The incidence rate of postoperative PVR was lower in the steroid group than in the control group, with no statistically significant difference observed.
Abbreviations: CI, confidence interval; M–H, Mantel–Haenszel test; PVR, proliferative vitreoretinopathy.

Figure 4 Forest plot of the postoperative PVR incidence rate (excluding grade C, Ahmadieh et al study). There was a statistically significant difference between the steroid group and the control group, when the study of PVR grade C was excluded.

Abbreviations: CI, confidence interval; M–H, Mantel–Haenszel test; PVR, proliferative vitreoretinopathy.

Figure 5 Forest plot of visual acuity evaluated at 6 months post-RRD surgery. There was no difference in visual acuity between the steroid group and the control group.

Abbreviations: CI, confidence interval; SD, standard deviation; IV, inverse variance; RRD, rhegmatogenous retinal detachment.

Table 2 Outcome indicators in the included trials

Reference	Year	na	Primary reattachment rateb	Final reattachment rateb	Reoperation for retinal redetachmentb
Dehghan et al^Citation29	2010	25/27	NA	NA	NA
Koerner et al^Citation28	2012	110/110	86.4/85.5	95.1/89.4	12.7/20.0
Ahmadieh et al^Citation30	2008	38/37	84.2/78.4	92.1/91.9	15.8/21.6

Notes:

a Case number in steroids group/case number in control group

b rate of event in steroids group/rate of event in control group.

Abbreviation: NA, not available.

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