ABSTRACT
PURPOSE: To evaluate the effect of posterior sub-Tenon triamcinolone acetonide injection combined with vitrectomy for idiopathic epiretinal membrane (ERM). METHODS: This study included 40 eyes of 40 patients who underwent vitrectomy and membrane peeling for idiopathic ERM. Triamcinolone acetonide (40 mg) was injected into the posterior sub-Tenon space following vitrectomy in 20 eyes of the injected group. The other 20 eyes that did not receive the injection were selected as the control group to match preoperative visual acuity and central macular thickness with the injected group. Pre- and postoperative best-corrected visual acuity, central macular thickness, intraocular pressure, and complications were compared between the 2 groups. RESULTS: The average visual acuity in the injected group improved from 0.56 +/- 0.23 (log MAR) at baseline to 0.52 +/- 0.36 at 1 month, 0.44 +/- 0.39 at 3 months, and 0.38 +/- 0.41 at 6 months postoperatively. Central macular thickness decreased from 456.2 +/- 86.2 to 399.0 +/- 60.1 at 1 month, 377.1 +/- 71.5 at 3 months, and 353.1 +/- 57.4 at 6 months postoperatively. In the control group, average visual acuity improved from 0.56 +/- 0.23 at baseline to 0.53 +/- 0.25 at 1 month, 0.41 +/- 0.20 at 3 months, and 0.37 +/- 0.24 at 6 months postoperatively. Central macular thickness decreased from 456.4 +/- 74.8 to 394.9 +/- 63.5 at 1 month, 377.2 +/- 56.8 at 3 months, and 358.0 +/- 57.2 at 6 months postoperatively. Significant differences in visual acuity and central macular thickness were not observed between the 2 groups before surgery and during the follow-up period. Intraocular pressure and complications were similar. CONCLUSIONS: Posterior sub-Tenon injection of triamcinolone acetonide combined with vitrectomy for idiopathic epiretinal membrane did not affect postoperative anatomical and functional outcomes.
Subject(s)
Humans , Epiretinal Membrane , Follow-Up Studies , Intraocular Pressure , Membranes , Triamcinolone Acetonide , Triamcinolone , Visual Acuity , VitrectomyABSTRACT
PURPOSE: To compare the efficacy of posterior sub-Tenon's capsule triamcinolone acetonide injection combined with modified grid macular photocoagulation (PSTI + MP) with intravitreal triamcinolone acetonide (IVTA) injection in the treatment of diffuse diabetic macular edema (DME). MATERIALS AND METHODS: Forty eyes of 33 patients with diffuse DME were randomly allocated into either PSTI + MP (20 eyes) or IVTA (20 eyes). Best corrected visual acuity (VA) and foveal thickness were measured. RESULTS: The ETDRS scores at baseline were 25.2 +/- 13.6 (mean +/- SD) letters in the PSTI + MP group, whereas 21.7 +/- 16.3 letters in the IVTA group. The ETDRS scores improved by 33.2 +/- 15.9, 34.7 +/- 16.6 and 30.9 +/- 19.0 letters in the PSTI + MP group whereas by 30.9 +/- 15.4, 30.1 +/- 17.9 and 31.5 +/- 15.0 letters in the IVTA group at 1, 3, and 6 months after the treatments, respectively. The VA improved significantly at 1 month and 3 months after both treatments (all p 0.05, Student's t-test). The foveal thicknesses at baseline and 1, 3, and 6 months after the treatments were 382.8 +/- 148.3, 309.1 +/- 131.3, 319.3 +/- 93.3, 340.4 +/- 123.5micrometer (mean +/- SD) in the PSTI + MP group vs. 369.1 +/- 123.1, 241.4 +/- 52.3, 277.5 +/- 137.4, 290.2 +/- 127.9micrometer in the IVTA group, respectively. Pairwise comparisons revealed significant decrease in foveal thickness at 1 month (p = 0.01, paired t-test) for the PSTI + MP group, and at both 1 month (p 0.05, Student's t-test). In contrast to the PSTI + MP group, where no complications were noted, the elevation of intra-ocular pressure in 3 of 20 eyes (15%) and a significant increase in average cataract grading were observed in the IVTA group. CONCLUSION: PSTI + MP treatment provides significant improvement of vision in patients with diffuse DME over 3 months, and achieves outcomes comparable to those after IVTA treatment, however, with fewer complications.