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R. Somani, C. J. Rudnisky, M. D. J. Greve, B. J. Hinz; Triamcinolone-Assisted Pars Plana Vitrectomy for Full Thickness Macular Holes. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4117.
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To evaluate the efficacy and safety of intravitreal triamcinolone acetonide (TA) assisted peeling of internal limiting membranes (ILM).
A retrospective review of 108 patients with full thickness macular holes who under went triamcinolone-assisted pars plana vitrectomy.
The use of triamcinolone allowed for improved visualization of the posterior hyaloid and internal limiting membrane. There were no intra-operative complications or signs of toxicity. Follow up data was available for 83% of patients. No post-operative endophthalmitis was observed. Anatomical closure of the macular hole was achieved in 96% of cases. Retinal detachment was observed in 5.6%. Intra-ocular pressure was found to be elevated above 22 mmHg in 32 (36%) cases. All cases of elevated intra-ocular pressure were treated with topical or oral agents alone. Average duration of treatment was 30 days. The incidence of cataract extraction was 47%.
TA-assisted vitrectomy is associated with a high macular hole closure rate. TA-assisted removal of the ILM appears to be safe as no cases of endophthalmitis was observed. While its use may be associated with an increase in post-operative intraocular pressure this effect is temporary and is controlled by short term medical therapy.
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