RESUMO
@#AIM: To compare the clinical effects of retinal detachment with choroidal detachment(RD/CD)treatment by posterior subcapsular Tenon injection triamcinolone acetonide and intravenous drip of dexamethasone combined vitrectomy.<p>METHODS: Totally 52 cases(52 eyes)of RD/CD patients in our hospital from March 2014 to October 2017 were retrospectively reviewed. According to the preoperative intervention methods, the patients were divided into two groups: A group and B group. Group A(27 cases, 27 eyes)received intravenous drip of dexamethasone once a day 3-5d before operation. Group B(25 cases, 25 eyes)received posterior subcapsular Tenon injection triamcinolone acetonide 5d before operation. The intraocular pressure, CD, retinal reattachment, visual acuity and complications were measured before and after the intervention.<p>RESULTS: After intervention, the intraocular pressure of group B was 8.09+3.56mmHg, which was significantly higher than 5.65+2.19mmHg before intervention in group B and 6.25+2.53mmHg after intervention in group A. The difference was statistically significant(<i>P</i><0.05). After intervention, the CD height of group A and B was 3.98(1.01, 5.34)mm and 0.92(0.03, 3.88)mm, significantly lower than that in group A and B before intervention, which was 5.22(3.14, 6.64)mm and 5.16(3.34, 7.71)mm. CD loci 6.0(3.0, 10.0)and 3.0(0.0, 6.0)were significantly lower than those of 11.0(9.0, 12.0)and 10.0(8.0, 12.0)before intervention. The CD height and the number of CD loci in group B were lower than those in group A(<i>P</i><0.05). From the last follow-up, the success rate of retinal reattachment in groups A and B were 78% and 96%, respectively(<i>P</i>>0.05). At 1, 3mo and the last follow-up, the visual acuity of group A was 1.69±0.79, 1.39±0.72 and 1.38±0.61 better than that of group A before intervention 2.06±0.28. The visual acuity of group B was 1.42±0.66, 1.29±0.56 and 0.97±0.51 better than that of group A before intervention 2.02±0.58. The visual acuity of group B was better than that of group A at the last follow-up, with statistical difference(<i>P</i><0.05). At 1 and 3mo after operation, 4 eyes in group A had high intraocular pressure, which was significantly lower than that of 11 eyes and 12 eyes in group B(<i>P</i><0.05). At the last follow-up, there was still 1 eye with high intraocular pressure in group A and 2 eyes in group B(<i>P</i>>0.05).<p>CONCLUSION: In the treatment of RD/CD, the effect of posterior subcapsular Tenon injection triamcinolone acetonide with vitrectomy is better than that of intravenous drip of dexamethasone combined vitrectomy, the intraocular pressure should be monitored after operation. If high intraocular pressure occurs, appropriate drug control or removal of triamcinolone acetonide from the posterior Tenon capsule is required.