Long-term outcomes of administration of intravitreal triamcinolone acetonide after posterior vitreous detachment during pars plana vitrectomy for proliferative diabetic retinopathy

Br J Ophthalmol. 2023 Apr;107(4):560-564. doi: 10.1136/bjophthalmol-2021-320332. Epub 2021 Nov 29.

Abstract

Aim: To evaluate the long-term outcomes of intravitreal triamcinolone acetonide (TA) administration after posterior vitreous detachment (PVD) during pars plana vitrectomy (PPV) for patients with proliferative diabetic retinopathy (PDR).

Methods: A total of 189 eyes (152 patients) who underwent PPV for severe PDR were reviewed. Intravitreal injection of TA (IVTA) was administered during PPV in 118 eyes (PPV+IVTA group), and 71 eyes did not receive IVTA (PPV group). Immediately after PVD, when most of the vitreous and proliferative membranes were removed, 0.1 mL TA (40 mg/mL) was injected into the vitreous cavity in the PPV+IVTA group. All patients were followed-up for least 12 months. Visual outcomes and postoperative complications were recorded and compared between the two groups.

Results: IVTA was helpful for proliferative membrane peeling and haemostasis during PPV. In the PPV+IVTA group, best-corrected visual acuity had significantly improved and the intraocular pressure was controlled well during the follow-up. The incidence of early recurrent vitreous haemorrhage after PPV was significantly lower in the PPV+IVTA group (1.7%) than in the PPV group (9.9%) (p=0.028).

Conclusion: The administration of IVTA after PVD during PPV can effectively improve the final visual outcomes and prevent postoperative complications in patients with severe PDR.

Keywords: retina; vitreous.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Diabetes Mellitus*
  • Diabetic Retinopathy* / complications
  • Diabetic Retinopathy* / drug therapy
  • Diabetic Retinopathy* / surgery
  • Glucocorticoids
  • Humans
  • Postoperative Complications / etiology
  • Triamcinolone Acetonide
  • Vitrectomy / adverse effects
  • Vitreous Body / surgery
  • Vitreous Detachment* / etiology

Substances

  • Triamcinolone Acetonide
  • Glucocorticoids