Intraocular Mitomycin-C in the Management of Recurrent Retinal Detachment and Proliferative Vitreoretinopathy: A Comparative Study With a Control Group.

Abstract

Purpose: This study aimed to evaluate the impact of intraoperative mitomycin-C (MMC) application during pars plana vitrectomy (PPV) on anatomical success, the need for additional surgery, and visual outcomes in patients with recurrent rhegmatogenous retinal detachment (RRD) associated with proliferative vitreoretinopathy (PVR) following previous retinal surgery.

Methods: This retrospective comparative study included 60 patients who underwent surgery for recurrent RRD with PVR between 2022 and 2024. Patients were divided into an MMC-treated group (n=30) and a control group (n=30). All patients underwent PPV, and outcomes including anatomical and functional success, silicone oil removal, and additional surgical interventions were compared between groups.

Results: Rates of retinal reattachment, PVR development, and functional improvement were comparable between groups. The primary anatomical success rate-defined as retinal reattachment with intraocular pressure above 6 mmHg at final postoperatively-was 83.3% in the MMC group and 70.0% in the control group. Secondary anatomical success-defined as successful silicone oil removal without redetachment or need for further intervention-was achieved in 50.0% and 46.7% of patients, respectively. Both groups showed statistically significant postoperative improvements in visual acuity; however, no significant difference was observed between them. Although the incidence of PVR was lower in the MMC group, the difference did not reach statistical significance.

Conclusion: Although MMC use was associated with more favorable anatomical outcomes and complication profiles in recurrent RRD cases, the lack of statistical significance warrants cautious interpretation, and larger prospective studies are needed to confirm its potential benefit as an adjuvant therapy.