ArticleGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie2026
Methotrexate as an adjunct to pars plana vitrectomy for the prevention and treatment of proliferative vitreoretinopathy in rhegmatogenous retinal detachment: A clinical study.
Article in Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
purposeTo examine the effectiveness and safety of adjunctive intravitreal methotrexate (MTX) in enhancing morphological and functional results following pars plana vitrectomy (PPV) in eyes affected by rhegmatogenous retinal detachment (RRD) accompanied by proliferative vitreoretinopathy (PVR).
methodsThis prospective randomized controlled trial included 50 eyes with RRD and PVR Grade C. Patients were randomized into two cohorts: Group A received PPV alone. Group B received PPV in conjunction with intravitreal MTX (200 µg/0.05 mL administered intraoperatively, followed by weekly injections for 4 weeks). All eyes underwent silicone oil tamponade. The main outcome was single-surgery anatomical success (SSAS), defined as maintained retinal attachment after silicone oil removal without additional surgery. Secondary outcomes included final anatomical success, visual acuity (BCVA), number of surgeries, and postoperative complications.
resultsSSAS was markedly elevated in the MTX group relative to controls (p < 0.001). Complete anatomical success was achieved in 100% of eyes treated with MTX, compared with 76% in the control group (p = 0.022). The MTX group exhibited markedly superior visual outcomes, with a greater improvement in BCVA (LogMAR, p < 0.001). Postoperative sequelae were markedly diminished in the MTX group, with reduced incidences of cystoid macular edema (p < 0.001) and epiretinal membrane development (p < 0.001). No instances of hypotony or ocular toxicity associated with MTX were noted.
conclusionsAdjunctive intravitreal methotrexate markedly improves morphological and functional outcomes in PVR-associated RRD, resulting in higher single-surgery success rates, reduced need for reoperation, and fewer postoperative sequelae.
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