VITRECTOMY AND COMPLETE DRAINAGE OF SUPRACHOROIDAL FLUID WITHOUT PERIOPERATIVE STEROIDS FOR RHEGMATOGENOUS RETINAL DETACHMENT COMBINED WITH CHOROIDAL DETACHMENT: A RANDOMIZED CLINICAL TRIAL.

Purpose: To investigate the surgical effect of complete drainage of suprachoroidal fluid (SCF) before vitrectomy to avoid perioperative steroids in rhegmatogenous retinal detachment combined with choroidal detachment (RRD-CD) eyes.

Methods: It was a prospective, randomized controlled trial. 58 eyes were randomly divided into the no steroids (NS) group and local steroids (LS) group, 29 eyes each, respectively. Patients in the LS group received a single preoperative periocular injection of methylprednisolone, while SCF drainage was performed before vitrectomy in eyes of the NS group. Follow-up assessments were performed at 1 week, 1 month, 3 months, 6 months postoperatively.

Results: The postoperative retinal reattachment rate was similar in the NS and LS groups (96.6% vs 93.1%, p = 1.00). Best-corrected visual acuity was improved in 72.4% and 75.9% in the NS and LS groups, respectively. Inflammation occurred in 5 eyes (17.2%) in the NS group and 6 eyes (20.7%) in the LS group (p = 0.74). Hypotony occurred in 11 (37.9%) and 14 (48.3%) eyes in the LS and NS groups (p = 0.43), respectively. Macular chorioretinal folds were found in 21 (72.4%) and 22 (75.9%) eyes in the LS and NS groups (p = 0.76), respectively. Hypotony and chorioretinal folds disappeared after 1 week postoperatively.

Conclusions: Preoperative steroids may not be necessary for RRD-CD patients if the SCF is completely drained before vitrectomy. Postoperative retinal reattachment does not depend on the use of preoperative steroids; instead, surgeons should focus on improving surgical techniques in RRD-CD to improve the retinal reattachment rate.