Efficacy of Intravitreal Triamcinolone Acetonide Injections at the End of Pars Plana Vitrectomy in Proliferative Diabetic Retinopathy

ABSTRACT

PURPOSE: To evaluate the efficacy of intravitreal injections of triamcinolone acetonide (TA) at the end of pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). METHODS: We analyzed 50 patients (52 eyes) who underwent PPV for treatment of PDR and received an intravitreal injection of 4 mg TA at the end of surgery. The study group (Group 1) was compared with a control group (Group 2, 46 patients, 51 eyes) (matched with the study group for preoperative parameters) who underwent PPV without intravitreal injection of TA. RESULTS: In Group 1, the grade of anterior chamber cells at postoperative days 1 and 7 was significantly lower than that of Group 2. There was slight mean IOP elevation in Group 1 at postoperative weeks 2, 3, 4, and 8, but it was not statistically significant. Forty-four eyes (84.6%) from Group 1 showed better visual acuity at the last follow-up than at the preoperative visit (Group 1). Thirty-two eyes (62.8%) from Group 2 showed better visual acuity at the last follow-up than at the preoperative visit. The degree of visual improvement was 0.75 logMAR in Group 1 and 0.59 logMAR in Group 2. Vitreous hemorrhage occurred in 9 eyes (17.3%) from Group 1 and in 19 eyes (37.3%) from Group 2. However, the differences in the occurrence of neovascularization in iris and neovascular glaucoma between two groups were not statistically significant. CONCLUSIONS: Intravitreal TA injection at the end of PPV seems to be effective in improving visual acuity and decreasing early postoperative inflammation and the frequency of vitreous hemorrhage.