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Steven Agemy, Johnstone Kim, Ankur Mehta, Chaesik Kim, Asheesh Tewari; Surgical removal of idiopathic epiretinal membrane with or without post-membrane peel intravitreal triamcinolone: A comparison of anatomical and functional outcomes. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3848.
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Our goal was to determine whether the addition of intravitreal triamcinolone at the end of vitrectomy with membrane peel improves functional and anatomical outcomes in patients with an epiretinal membrane with associated macular edema.
This is a retrospective chart review of patients who underwent pars plans vitrectomy with membrane peel by a single vitreoretinal surgeon (A.T.) for idiopathic epiretinal membrane with macular edema at the Kresge Eye Institute from 1/2009 to 2/2012. Patients were divided into two groups: the group that received intravitreal injection of 4mg of triamcinolone acetonide at the end of surgery and the group that did not. All patients were followed for a minimum of 3 months. Best-corrected visual acuity, central macular thickness by optical coherence tomography and intraocular pressure were recorded from each follow-up visit.
Our study consisted of 20 eyes of 20 patients in total including 10 eyes in the triamcinolone group and 10 eyes in the control group. The mean change from preoperative best-corrected visual acuity (LogMAR) in the injected group at 1, 3, 6, and 9 months was +0.09, +0.10, -0.02 and +0.22; mean change in the control group was -0.09, +0.24, +0.20, and -0.05. There was no statistically significant difference in the change from preoperative best-corrected visual acuity at each visit between the two groups. The mean decrease from preoperative central macular thickness (µm) of the injected group at 3, 6, and 9 months was 109.2, 146.0, and 152.5; mean decrease in the control group was 104.0, 137.4, and 133.3. There was no statistically significant difference in the decrease from preoperative central macular thickness at each visit between the two groups. The mean change from preoperative intraocular pressure (mmHg) of the injected group at 1, 3, 6, and 9 months was +3.1, +3.6, +1.0, and +2.0; mean change in the control group was -0.6, -0.3, -1.8, and -2.7. There was a statistically significant difference in the mean change from preoperative IOP between the two groups at 1 month (p=0.04) and 3 months (p=0.04).
Pars plana vitrectomy with membrane peel resulted in improvement in visual acuity and macular thickening while the addition of intravitreal triamcinolone at the end of the surgery did not improve postoperative anatomical and functional outcomes.
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