Methotrexate shows promise in preventing retinal surgery complications

Methotrexate (MTX) shows promise as an adjunctive treatment for preventing proliferative vitreoretinopathy (PVR) after rhegmatogenous retinal detachment surgery, with evidence of improved retinal reattachment rates, better visual outcomes, and reduced re-operation rates, according to a study.

The review analyzed studies from PubMed, EMBASE, and Open Access databases, focusing on MTX’s role in PVR prevention and treatment. Researchers examined patient demographics, dosages, administration methods, and outcomes in 180 eyes undergoing vitrectomy and additional procedures like scleral buckling and gas tamponade.

Retinal reattachment rates ranged from 74% to 92%, with an average rate of 85% for intraoperative MTX infusion. Patients receiving MTX also experienced improvements in best corrected visual acuity and had a significantly lower re-operation rate for retinal detachment (18%) compared to those not treated with MTX.

Despite encouraging findings and minimal adverse events, the review highlighted the need for further research. Current evidence is limited by small sample sizes, study quality, and variability in treatment protocols.

Reference
Toh VTR, Gerard G, Tay ZQ, et al. Efficacy and safety of methotrexate in the treatment of proliferative vitreoretinopathy: a systematic review. Eye (Lond). 2024 Dec 14. doi: 10.1038/s41433-024-03503-5. Epub ahead of print. PMID: 39674839.