Adjunctive daunorubicin in the treatment of proliferative vitreoretinopathy: reult of a multicenter clinical trial Original Reearch Article

PURPOE: To ae the efficacy and afety of adjunctive daunorubicin during vitrectomy urgery in eye with idiopathic proliferative vitreoretinopathy (PVR). METHOD: Two hundred eighty-ix eye (286 patient) with tage C2 (Retina ociety Claification, 1983) or more advanced preoperative PVR in which urgery with ilicone oil wa planned were enrolled in a multicenter, propective, randomized, controlled clinical trial. tandardized urgery plu adjunctive daunorubicin perfuion wa compared with urgery alone. Outcome aeed were retinal attachment without additional vitreoretinal urgery 6 month after tandardized urgery, number of and time until vitreoretinal reoperation within 1 year of tandardized urgery, and change in viual acuity 1 year after tandardized urgery, evaluated by photodocumentation, number of reoperation, and meaurement of bet-corrected viual function. Outcome were determined 6 month after operation and reevaluated after 1 year of follow-up. REULT: ix month after tandardized urgery, complete retinal reattachment without additional vitreoretinal urgery wa achieved in 62.7% (89/142) of eye in the daunorubicin group v 54.1% (73/135) in the control group (P = .07, one-ided). However, in the daunorubicin group, ignificantly fewer vitreoretinal reoperation were performed within 1 year potoperatively (P = .005, one-ided) to achieve the ame overall 1-year retinal reattachment rate (80.2% [105/131] v 81.8% [103/126]). The rate of patient with no vitreoretinal reoperation wa 65.5% (95/145) in the daunorubicin group v 53.9% (76/141) in the control group. There wa no difference in the bet-corrected viual acuity. No evere advere effect related to daunorubicin wa identified. CONCLUION: Although the rate of anatomic ucce after 6 month failed to how ignificance, ome benefit of the adjunctive treatment exit, epecially a tendency toward increaed rate of reattachment and a ignificant reduction in the number of reoperation. Thi how that human PVR i amenable to pharmacologic treatment.