Abstract General Information

Título / Title

TOPICAL NETARSUDIL REDUCES PROLIFERATIVE VITREORETINOPATHY ASSOCIATED WITH RETINAL DETACHMENT.

Introdução / Purpose

The Rho-kinase (ROCK) pathway contributes to Proliferative Vitreoretinopathy (PVR) development and contraction of membranes. This study evaluates the use of a ROCK inhibitor, netarsudil (NET), in reducing the need for surgery for PVR associated Rhegmatogenous Retinal Detachment (RRD).

Material e Método / Methods

We evaluated every pars plana vitrectomy for PVR C associated RRD performed by a single surgeon between February 2019 and September 2024. Patients treated after February 2022 received one NET 0.02% drop nightly until at least post-op month 3. Exclusions included follow-up <3 months, no pre-op PVR, PVR B or better, uveitis, prior intravitreal methotrexate, and RRDs with macular holes. Surgeries followed similar techniques, with PVR removal and a scleral buckle placed for those without one. Retinectomies, perfluoro-n-octane (PFO) use and tamponade were decided at surgeon’s discretion. Reoperation rates for RD and potentially confounding factors were compared between groups.

Resultados / Results

29 surgeries (21 patients) were included, with 9 receiving post-op NET. Mean age was 71.44 in the NET group and 66.05 in controls (p=0.1). No pre-op differences were found in sex, smoking, high myopia, lens status, RRD/PVR extent, or best corrected visual acuity. No reoperations for new PVR occurred in the NET group vs. 8 in controls (p=0.033) and the estimated 95% confidence intervals for the reoperation rate did not overlap. The rate of internal limiting membrane peeling, PFO use, retinectomy and retinectomy size were similar between the groups. In the NET group, 1 surgery received C3F8 and 8 silicon oil, compared to 6 and 14 in controls (p=0.382). Oil was removed in 4 NET patients and 6 controls (p=1). The rates of post-op hypotony, hypertension, corneal epitheliopathy, epiretinal membrane and macular edema were not different.

Discussão e Conclusões / Conclusion

NET used after PVR related RRD repair effectively prevented PVR associated reoperations, without inducing complications. These promising novel results provide foundation for future trials.

Palavras Chave

Proliferative vitreoretinopathy, Rho-kinase, Netarsudil, Retinal detachment, retina, ROCK, PVR.