One-year results of a multicenter controlled clinical trial of triamcinolone in pars plana vitrectomy

Graefes Arch Clin Exp Ophthalmol. 2008 Jul;246(7):959-66. doi: 10.1007/s00417-008-0829-0. Epub 2008 Apr 23.

Abstract

Purpose: To evaluate the 1-year results of using triamcinolone acetonide (TA) in pars plana vitrectomy (PPV).

Design: Multicenter prospective controlled clinical trial.

Setting and study population: the study population comprised 774 eyes from patients treated at eight Japanese hospitals, among which 391 eyes underwent TA-assisted PPV and 383 control eyes underwent conventional PPV. The patients were assigned to the two groups using a single-blind quasi-randomization approach within the participating clinical centers.

Intervention: intra-operative use of TA to aid visualization of the vitreous.

Main outcome measures: changes of visual acuity, post-operative complications (including additional surgery), and adverse events occurring within 1 year of the operation were compared between the TA-PPV group and the conventional PPV group.

Results: The visual acuity improved over time, and no significant differences were found between the two groups (log-rank versus TA, P = 0.98 for improvement, P = 0.26 for deterioration). The logistic regression model also showed that the intra-operative use of TA was not a significant factor for the improvement of visual acuity [P = 0.91, odds ratio (OR) = 1.10, 95% confidence interval (95%CI) = 0.860-1.183)] after adjustments for age, gender, and diagnosis. Intra-operative TA was not a significant factor for the need for additional surgery (log-rank test P = 0.45, logistic regression test P = 0.35, OR = 1.23, 95%CI = 0.797-1.911]. No serious adverse events related to surgery were observed.

Conclusions: This 1-year follow-up study of a controlled clinical trial showed that TA-assisted PPV had neither a positive nor a negative effect on visual acuity, the incidence of additional surgeries, or adverse events compared with conventional PPV.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Diabetic Retinopathy / surgery
  • Female
  • Glucocorticoids*
  • Humans
  • Intraoperative Care
  • Male
  • Middle Aged
  • Postoperative Complications
  • Prospective Studies
  • Retinal Detachment / surgery
  • Single-Blind Method
  • Triamcinolone Acetonide*
  • Visual Acuity
  • Vitrectomy / methods*
  • Vitreoretinopathy, Proliferative / surgery
  • Vitreous Body / pathology*

Substances

  • Glucocorticoids
  • Triamcinolone Acetonide