Intravitreal Triamcinolone Acetonide as Adjunctive Treatment in Vitrectomy for Proliferative Diabetic Retinopathy

ABSTRACT

PURPOSE: This study evaluated the safety and efficacy of crystalline triamcinolone acetonide (TA) in pars plana vitrectomy for proliferative diabetic retinopathy. METHODS: A total of 152 eyes of 143 patients were enrolled in the study, and divided into 3 groups Group I underwent pars plana vitrectomy without intravitreal injection of TA, group II underwent TA-assisted vitrectomy, and group III underwent TA-assisted vitrectomy and received an intravitreal injection of 4 mg TA at the end of surgery. RESULTS: In Groups I, II and III, 31 eyes (62.0%), 35 eyes (67.3%), and 41 eyes (82.0%), respectively, showed frequency of gain in visual acuity, group III showed greater improvements in vision after surgery than group I; the difference was statistically significant. Four eyes (8.0%) in group I, 12 eyes (23.1%) in group II, and 12 eyes (24.0%) in group III had an intraocular pressure higher than 21 mmHg after the operation; there were statistically significant differences in groups II and III compared to group I (P=0.04, P=0.03, respectively). Ten eyes (20.0%) in group I, 3 eyes (5.8%) in group II, and 3 eyes (6.0%) in group III needed additional surgery. Groups II and III, which received TA-assisted vitrectomy, had lower incidences of re-operation than group I (P=0.03, P=0.04, respectively). CONCLUSIONS: Triamcinolone acetonide-assisted vitrectomy appears to be a potentially useful way to reduce the incidence of re-operation and an intravitreal injection of TA at the end of surgery may be useful for improving postoperative visual acuity.