Outcomes of Primary Rhegmatogenous Retinal Detachment Repair With Adjunctive Mitomycin C

Purpose: To evaluate anatomic and visual outcomes following primary repair of rhegmatogenous retinal detachment (RRD) with adjunctive intraoperative mitomycin C (MMC). Methods: This retrospective, single-center case series included eyes undergoing primary RRD repair with intraoperative MMC between March and December 2020. Eyes with retinal detachment duration <4 weeks and no proliferative vitreoretinopathy at presentation were included. MMC dose (low-medium: 0.002-0.12 mg; high: 0.15-0.2 mg), concentration, and exposure duration were recorded. The primary endpoint was recurrent retinal detachment requiring re-intervention. Secondary endpoints included longitudinal best-corrected visual acuity (BCVA; Early Treatment Diabetic Retinopathy Study [ETDRS] letters) and clinically apparent adverse events. Results: A total of 80 eyes from 78 patients (mean age, 62 years; 73% male) were analyzed. Macula-off retinal detachment was present in 56% of eyes. Redetachment occurred in 3 eyes (3.8%), all in the low-medium dose group. Mean BCVA improved from 38 to 66 ETDRS letters ( P < .001), with no significant dose-dependent effect ( P = .704). No clinically apparent hypotony, anterior segment ischemia, or retinal toxicity attributable to MMC was observed during follow-up. Conclusions: In this pilot series of primary RRD without proliferative vitreoretinopathy, intraoperative MMC was not associated with clinically apparent toxicity and demonstrated favorable short-term anatomic and visual outcomes. Prospective controlled studies are warranted to confirm these findings.