Triamcinolone acetonide in silicone-filled eyes as adjunctive treatment for proliferative vitreoretinopathy: a randomized clinical trial.

Abstract

OBJECTIVE:

To evaluate the effect of adjunctive intraocular triamcinolone acetonide (TA) in silicone-filled eyes on outcomes of vitreoretinal surgery for proliferative vitreoretinopathy (PVR).

DESIGN:

Prospective, randomized, controlled clinical trial.

PARTICIPANTS:

Seventy-five eyes with rhegmatogenous retinal detachment and PVR grade C (posterior, anterior, or both) undergoing vitrectomy combined with silicone oil tamponade were included. Of these, 38 eyes were assigned randomly to the adjunctive treatment, whereas 37 eyes served as controls.

INTERVENTION:

All eyes underwent pars plana vitrectomy, membrane peeling, and silicone oil exchange, with or without relaxing retinotomy or retinectomy. In the treatment group, 4 mg TA was injected into the silicone-filled vitreous cavity at the end of the procedure. Silicone oil was removed 3 months after surgery in eyes with attached retinas.

MAIN OUTCOME MEASURES:

The primary outcome measure was retinal reattachment rate at 6 months. Secondary outcome measures included visual acuity, rate of recurrent PVR, reoperation rate, and rise of intraocular pressure.

RESULTS:

Retinal reattachment without any reoperation was achieved in 32 eyes (84.2%) and 29 eyes (78.4%) in the adjunctive treatment and control groups, respectively, at 6 months (P = 0.5). No statistically significant difference was observed between the 2 groups in terms of any of the secondary outcome measures (P>0.05).

CONCLUSIONS:

The outcomes of vitreoretinal surgery for established PVR are not improved significantly by adjunctive TA injection in silicone-filled eyes.

• Authors: Hamid Ahmadieh, Mostafa Feghhi, Homa Tabatabaei, Nasser Shoeibi, Alireza Ramezani, Mohammad Reza Mohebbi
• Journal: Ophthalmology (Ophthalmology) Vol. 115 Issue 11 Pg. 1938-43 (Nov 2008) ISSN: 1549-4713 [Electronic] United States
• PMID: 18584876 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Immunosuppressive Agents
• Silicone Oils
• Triamcinolone Acetonide

Topics

• Combined Modality Therapy
• Female
• Humans
• Immunosuppressive Agents (administration & dosage)
• Injections
• Intraocular Pressure
• Male
• Middle Aged
• Prospective Studies
• Retinal Detachment (surgery)
• Silicone Oils (administration & dosage)
• Triamcinolone Acetonide (administration & dosage)
• Vitrectomy
• Vitreoretinopathy, Proliferative (drug therapy, surgery)
• Vitreous Body