Role of Sub-Silicone Oil Application of Triamcinolone Acetonide (TA) Drops on Outcomes After 360° Relaxing Retinectomy in Extreme Proliferative Vitreoretinopathy Cases- A Pilot Study.
Abstract Purpose: To perform a pilot study to evaluate the role of sub-silicone oil Triamcinolone Acetonide (TA) crystal drops in complex Retinal Detachment (RD) with extreme proliferative vitreoretinopathy (PVR) requiring 360-degree relaxing retinectomy (RR). Design: It was a retrospective pilot studyMaterials & methods : It was a retrospective, case-control pilot study. TA assisted 23G or 25G vitrectomy was done in 24 complex RDs with extreme PVR where 360 degree RR had to be performed. Group A (n=13) included cases where additional TA crystal drops were applied, after settling the detached retina, over the site of RR under silicone oil (SO 5000 cSt) tamponade. In control arm, group B (n=11), additional TA crystals were not applied. Main outcomes measured : Mean pre and post operative BCVA, ultra-widefield retinograph by Optos 200Tx, macular OCT and the propensity to remove silicone oil were measured. Results: Mean preoperative and postoperative BCVA at final follow up were Log MAR 2.69 (20/9795) ± 0.41 and Log MAR 1.51 (20/647) ±0.90 (p<0.05) respectively in Group A and Log MAR 2.9 (20/15886) and Log MAR 2.37 (20/4688) ±0.86 (p<0.05) respectively in group B. Visual improvement in group A was significantly better than group B (two-sample t-test, p<0.05) with significantly less recurrence of RD (Fisher’s Exact Test, p=0.002). Silicone oil removal was done significantly more in group A (Fisher’s Exact Test, p=0.0017). Conclusion: Sub-silicone oil TA crystals application over sites of RR after 360-degree relaxing retinectomy leads to improved postoperative visual recovery as well as improved anatomical outcomes with fewer complications.