Intraoperative intravitreal triamcinolone decreases macular edema after vitrectomy with phacoemulsification
D Wilkin Parke III, Robert A Sisk, Timothy G Murray
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL, USA
Background: The purpose of this study was to evaluate the incidence and amount of macular edema by optical coherence tomography (OCT) after combined small gauge sutureless vitrectomy with phacoemulsification and intravitreal triamcinolone.
Methods: This retrospective case series included 194 consecutive eyes undergoing nonemergent vitrectomy with phacoemulsification and intravitreal triamcinolone. Ninety-one eyes had preoperative and postoperative OCT available and were included in the analysis. The eyes were evaluated for retinal thickness with preoperative and postoperative OCT, and for preoperative and postoperative best-corrected visual acuity. The main outcome measures were retinal thickness, OCT appearance, and best-corrected visual acuity.
Results: The incidence of macular edema in all eyes preoperatively was 64.8% and postoperatively was 50.5%. Mean central subfield and center point thickness in eyes with macular edema preoperatively were 361 µm and 349 µm, respectively, and postoperatively were 315 µm and 304 µm, respectively. In eyes without preoperative macular edema, mean preoperative central subfield and center point thickness were, respectively, 210 µm and 181 µm versus 220 µm and 192 µm postoperatively. Best corrected visual acuity improved from 20/190 preoperatively to 20/150 at postoperative month 1 and 20/110 at month 6. Postoperative intraocular pressure ≥ 25 mmHg was observed in 7.7% of eyes, none of which required surgical intervention for steroid-induced glaucoma.
Conclusion: Use of intravitreal triamcinolone with combined vitrectomy and phacoemulsification may play an important role in modulating postoperative macular edema. Adverse pressure rise is infrequent and usually limited.
Keywords: triamcinolone, macular edema, vitrectomy, corticosteroids
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