Long-term outcomes of administration of intravitreal triamcinolone acetonide after posterior vitreous detachment during pars plana vitrectomy for proliferative diabetic retinopathy

AimTo evaluate the long-term outcomes of intravitreal triamcinolone acetonide (TA) administration after posterior vitreous detachment (PVD) during pars plana vitrectomy (PPV) for patients with proliferative diabetic retinopathy (PDR).MethodsA total of 189 eyes (152 patients) who underwent PPV for severe PDR were reviewed. Intravitreal injection of TA (IVTA) was administered during PPV in 118 eyes (PPV+IVTA group), and 71 eyes did not receive IVTA (PPV group). Immediately after PVD, when most of the vitreous and proliferative membranes were removed, 0.1 mL TA (40 mg/mL) was injected into the vitreous cavity in the PPV+IVTA group. All patients were followed-up for least 12 months. Visual outcomes and postoperative complications were recorded and compared between the two groups.ResultsIVTA was helpful for proliferative membrane peeling and haemostasis during PPV. In the PPV+IVTA group, best-corrected visual acuity had significantly improved and the intraocular pressure was controlled well during the follow-up. The incidence of early recurrent vitreous haemorrhage after PPV was significantly lower in the PPV+IVTA group (1.7%) than in the PPV group (9.9%) (p=0.028).ConclusionThe administration of IVTA after PVD during PPV can effectively improve the final visual outcomes and prevent postoperative complications in patients with severe PDR.

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Intravitreal Triamcinolone Acetonide as an Additional Tool in Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy

European Journal of Ophthalmology ◽

10.1177/112067210301300508 ◽

2003 ◽

Vol 13 (5) ◽

pp. 468-473 ◽

Cited By ~ 27

Author(s):

J.B. Jonas ◽

A. SÖfker ◽

R. Degenring

Keyword(s):

Visual Acuity ◽

Diabetic Retinopathy ◽

Triamcinolone Acetonide ◽

Proliferative Diabetic Retinopathy ◽

Pars Plana Vitrectomy ◽

Control Group ◽

Study Group ◽

Intravitreal Triamcinolone ◽

Intravitreal Triamcinolone Acetonide ◽

Pars Plana

Purpose To evaluate the safety and efficacy of intravitreal injections of crystalline triamcinolone acetonide as an adjunctive procedure in pars plana vitrectomy for proliferative diabetic retinopathy. Methods This nonrandomized comparative study included 30 patients (32 eyes) who underwent standardized pars plana vitrectomy for treatment of proliferative diabetic retinopathy and who received an intravitreal injection of 25 mg triamcinolone acetonide at the end of surgery. Mean follow-up time was 5.60 ± 5.14 months. The study group was compared with a control group (32 eyes) matched with the study group for preoperative and intraoperative parameters and who underwent pars plana vitrectomy for proliferative diabetic retinopathy without intravitreal injection of triamcinolone acetonide. Results The study group and the control group did not vary significantly in frequency of postoperative retinal detachment, re-pars plana vitrectomy, or postoperative enucleation or phthisis bulbi, or in best postoperative visual acuity, visual acuity at end of the study, or gain in visual acuity. Conclusions In this pilot study, the study group with pars plana vitrectomy and intravitreal triamcinolone acetonide injection compared with the nonrandomized control group without intravitreal triamcinolone acetonide injection did not show a higher than usual rate of postoperative complications. As a corollary, however, the data do not suggest the adjunct use of 25 mg intravitreal triamcinolone acetonide combined with pars plana vitrectomy as treatment of proliferative diabetic retinopathy.

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