Triamcinolone-assisted pars plana vitrectomy for retinal disease

Abstract

Purpose: To determine whether triamcinolone acetonide (TA ) staining facilitates posterior hyaloid removal in patients undergoing pars plana vitrectomy (PPV) for retinal disease.

Methods: A triamcinolone acetonide(TA)-assisted vitrectomy was performed on patients with the following disease: proliferative diabetic retinopathy (5 eyes), central retinal vein occlusion (5 eyes), macuar hole (3 eyes), and epiretinal membrane (2 eyes). Eyes without apparent preoperative posterior vitreous detachment were enrolled in this study. After a core PPV, TA aqueous suspension (40 mg/ml) was injected into the mid vitreous cavity to visualize the posterior hyaloid, thus allowing a complete posterior hyaloid separation and removal. The visual acuity, intraocular pressure (IOP), tamponade, corneal pathology, after-cataract, vitreous hemorrhage, and necessity for reoperation were thereafter examined for at least 3 months after surgery.

Results: In all patients, the vitreous body was clearly seen by means of triamcinolone during surgery, and complete removal of posterior hyaloid was facilitated and confirmed. Retina was attached in 14 of 15 eyes, and vision acuity was improved in 9 of 15 eyes. Two eyes showed transient postoperative IOP elevation, 2 eyes had after cataract formation and l eye had cataract progression. Vitreous hemorrhage occurred in 1 eye. No eye had corneal pathology.

Conclusion: Triamcinolone improved the visibility of the hyaloid and the safety of surgical procedures during PPV. No obvious adverse effect due to toxicity of TA accrued in TA-assisted PPV.