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H. M. Bahrani, D. S. Dyer; Efficacy of Using Kenalog 5% Intravitreal Injection as a New Method for Staining Inner Limiting Membrane (ILM) During Epi-Retinal Membrane (ERM) Surgery. Invest. Ophthalmol. Vis. Sci. 2007;48(13):78.
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© ARVO (1962-2015); The Authors (2016-present)
To assess the efficacy and surgical convenience of Kenalog 5% compared to Kenalog 100% and ICG (IndoCyanine Green dye) during ERM peeling surgery.
A total number of 80 patients were separated into 3 groups: A, B & C. Group A included patients who had Kenalog 5% Intravitreal Injection while group B and group C had Kenalog 100% and ICG, respectively. In respect to measuring visual acuity (VA), there were 34 eyes in group A, 36 eyes in group B, and 10 eyes in group C. In respect to measuring intra ocular pressure (IOP), there were 33 eyes in group A, 36 eyes in group B, and 10 eyes in group C. Pre-operative VA and IOP were compared with post-operative VA and IOP at 30 days for all groups. For statistical analysis, ANOVA and Post Hoc multiple comparisons test analyses were used.
There were no significant differences between all groups in respect to improvement in VA or reduction in IOP at post-operative day 30. Based on the ANOVA analysis, the P- values were 0.767 for the change in VA and 0.110 for the change in IOP between all groups. The multiple comparisons obtained by Post Hoc analysis also revealed no significance, but a trend favoring Group A showed in reducing IOP. In respect to changes in VA, P-values were: A vs. B 0.859, A vs. C 0.953; while in respect to changes in IOP, P-values were: A vs. B 0.208, A vs. C 0.192. In addition, Kenalog 5% was not associated with any complications during the thirty-day follow-up period. We did find that using Kenalog 5% was more convenient than Kenalog 100% since it did not clog the forceps and did not obscure the surgeon’s view during ILM peeling.
This study suggests that Kenalog 5% is as effective and more convenient in coating the ILM compared to Kenalog 100% and ICG. Kenalog 100% is believed to improve VA by decreasing post-operative macular edema. Since there was no significant difference in improving VA between Kenalog 5% & 100 %, there is no additional benefit in using 100%. In addition, Kenalog 5% is not associated with the toxicity that ICG has been implicated in some prior articles. However, additional investigations using more samples are needed to compare all three methods.
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