Subtenon Triamcinolone Acetonide Removal for Uncontrolled Ocular Hypertension After Posterior Subtenon Injection of Triamcinolone Acetonide

J Glaucoma. 2016 Mar;25(3):e268-72. doi: 10.1097/IJG.0000000000000296.

Abstract

Purpose: To report the control of intraocular pressure (IOP) after removal of subtenon triamcinolone acetonide (TA) plaques in patients with uncontrolled ocular hypertension after posterior subtenon injection of triamcinolone acetonide (PSTA) and to evaluate the factors associated with rapid IOP normalization after subtenon TA removal.

Materials and methods: Data from 8 eyes of 7 patients receiving excision of subtenon TA plaques for uncontrolled ocular hypertension after PSTA in 1 hospital from June 2010 to December 2012 were retrospectively collected. The percentage of IOP lowering on postoperative day 1 and the time to IOP normalization after subtenon TA removal were reported. Pearson correlation analysis was used to analyze the factors for rapid IOP normalization after subtenon TA removal.

Results: The IOP lowering on postoperative day 1 ranged from 12% to 75%. All cases achieved IOP normalization within a mean of 2.5±1.9 days (range, 1 to 5 d) after subtenon TA removal. Fewer kinds of antiglaucoma agents used before subtenon TA removal was associated with greater IOP lowering on postoperative day 1 (P=0.01) and more rapid return to normal IOP (P=0.01). Older age and more time from PSTA to ocular hypertension were both correlated with shorter time to achieve IOP normalization after operation (P=0.01 and 0.02, respectively).

Conclusions: In medically uncontrolled ocular hypertension after PSTA, excision of subtenon TA plaques provided IOP normalization as rapidly as 1 to 5 days. Fewer preoperative antiglaucoma agents, older age, and more time from PSTA to ocular hypertension were correlated with more rapid IOP normalization after subtenon TA removal.

MeSH terms

  • Adult
  • Aged
  • Device Removal*
  • Drug Implants
  • Female
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / adverse effects*
  • Humans
  • Injections, Intraocular
  • Intraocular Pressure / physiology*
  • Macular Edema / drug therapy
  • Male
  • Middle Aged
  • Ocular Hypertension / chemically induced*
  • Ocular Hypertension / physiopathology*
  • Retrospective Studies
  • Tenon Capsule / drug effects*
  • Tonometry, Ocular
  • Triamcinolone Acetonide / administration & dosage
  • Triamcinolone Acetonide / adverse effects*

Substances

  • Drug Implants
  • Glucocorticoids
  • Triamcinolone Acetonide