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The efficacy of preoperative posterior subtenon injection of triamcinolone acetonide in noninfectious uveitic patients with secondary glaucoma undergoing trabeculectomy

Authors Keorochana N, Kunasuntiwarakul S, Treesit I, Choontanom R

Received 10 July 2017

Accepted for publication 12 October 2017

Published 21 November 2017 Volume 2017:11 Pages 2057—2063

DOI https://doi.org/10.2147/OPTH.S145957

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser


Narumon Keorochana, Sutheera Kunasuntiwarakul, Isaraporn Treesit, Raveewan Choontanom

Department of Ophthalmology, Phramongkutklao Hospital, Phramongkutklao College of Medicine, Bangkok, Thailand

Objective: The aim of this study was to evaluate the efficacy and safety of preoperative posterior subtenon injection of triamcinolone acetonide (PSTA) in noninfectious uveitic patients with secondary glaucoma undergoing primary trabeculectomy with mitomycin C.
Design: This was a retrospective study.
Patients and methods: We reviewed the medical records of 10 noninfectious uveitic patients, who had received a single preoperative PSTA 40 mg/1 mL, with secondary glaucoma undergoing primary trabeculectomy with mitomycin C. We collected data before and after surgery on intraocular pressure (IOP), anterior chamber (AC) cells, best-corrected visual acuity (BCVA), morphologic characteristics of the filtering bleb and complications.
Results: The mean time between injection and surgery was 7.8±3.88 days. Postoperative IOP level was significantly lower than preoperative level (31.3±11.44 mmHg) at all visits (P<0.02). Antiglaucoma medications were decreased from preoperative (4.9±0.88) to 12-month postoperative (0.8±1.31; P-value <0.001) and also discontinued in seven eyes (70%). About 12 months after surgery, eight eyes (80%) with qualified success and two eyes (20%) with failed treatment were recorded. AC cells and BCVA did not differ significantly from baseline; however, all inflammations were controlled successfully. Most desirable bleb morphology was shown at 12 months as well. Complications were blepharoptosis and hypotony maculopathy in two eyes (20%).
Conclusion: A preoperative PSTA may be an effective and safe option in controlling intraocular inflammation and maintaining bleb function after trabeculectomy in noninfectious uveitic patients with secondary glaucoma during a 12-month period.

Keywords: periocular injection, steroid, uveitis, triamcinolone acetonide

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