RESUMO
BACKGROUND AND OBJECTIVE: To report the efficacy of intravitreal triamcinolone acetonide as an adjuvant in the surgical management of cases with advanced proliferative vitreoretinopathy (PVR). PATIENTS AND METHODS: Patients with complicated rhegmatogenous retinal detachment and PVR grade C2 or greater were recruited for this interventional, noncomparative, prospective study. All patients underwent three-port pars plana vitrectomy, membrane peeling, laser photocoagulation, and silicone oil injection to reattach the retina followed by 0.1 mL (4 mg) of triamcinolone acetonide injected through the pars plana into the silicone oil. All patients had supplemental laser therapy around retinal breaks and retinectomy edges at 1 to 2 weeks postoperatively. RESULTS: Patients included 15 males and 9 females, with an average age of 53.6 years (range: 15 to 84 years) and PVR grade C2 to PVR C9. The mean follow-up period was 11.0 months (range: 3 to 26 months). Twenty-one (87.5%) patients had attached retinas at the final followup visit. Visual acuity improved in all patients following surgery (P < .05). CONCLUSION: Triamcinolone acetonide may have potential as an adjuvant in the treatment of retinal detachment with PVR. Further research is required to evaluate the efficacy of this adjuvant treatment.
Assuntos
Glucocorticoides/uso terapêutico , Descolamento Retiniano/cirurgia , Triancinolona Acetonida/uso terapêutico , Vitrectomia , Vitreorretinopatia Proliferativa/cirurgia , Adolescente , Idoso , Idoso de 80 Anos ou mais , Quimioterapia Adjuvante , Feminino , Seguimentos , Glucocorticoides/administração & dosagem , Humanos , Injeções , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Descolamento Retiniano/complicações , Descolamento Retiniano/etiologia , Descolamento Retiniano/fisiopatologia , Perfurações Retinianas/complicações , Índice de Gravidade de Doença , Resultado do Tratamento , Triancinolona Acetonida/administração & dosagem , Acuidade Visual , Vitreorretinopatia Proliferativa/complicações , Vitreorretinopatia Proliferativa/fisiopatologia , Corpo VítreoRESUMO
Orbital cellulitis due to presumed gas-producing organisms has been associated with poor visual prognosis. We report successful visual recovery in a 14-year-old boy with orbital cellulitis and gas in the orbit on CT scan. The patient was treated with intravenous antibiotics and prompt orbital decompression. Pus from the sinus aspirate and orbital drain grew H. influenzae and Gram-negative bacilli. Repeat orbital surgery with drainage of residual abscess was performed and the patient made a complete recovery.