Purchase this article with an account.
P.G. Hykin, Z.K. Ockrim, E. Ezra, Z. Gregor; Diabetic Macular Edema: Par Plana Vitrectomy and Intravitreal Triamcinolone . Invest. Ophthalmol. Vis. Sci. 2005;46(13):1443.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: : To ascertain the efficacy of combined surgical and pharmacological treatment for diffuse diabetic macular edema Methods: 12 patients with Clinically Significant Macular Edema (CSME) resistant to prior laser treatment were prospectively evaluated with optical coherence tomography (OCT), and their best corrected visual acuities (BCVA) were tested by an independent observer. All patients underwent vitrectomy, removal of attached vitreous cortex without peeling of the ILM and, at the end of the operation, an injection of 4mg of triamcinolone into the vitreous cavity. They were followed up for a median of 52 weeks. Results: A marked reduction in median retinal thickness could be detected from baseline (490um) at 1 week (192.5um) and 1 month (228um). At 12 months the median retina thickness was decreased compared to baseline (383.5um). This trend reduced the need for re–injection of triamcinolone. The BCVA had improved one line or more in 6/12 patients at 18 weeks and 3/8 patients at 52 weeks. 2/12 patients showed at reduction in BCVA through–out the follow up period. No surgical complications were encountered. Conclusions: The rapid and beneficial effect of intraocular steroids in CSME was confirmed. Whereas in intact eyes this effect diminishes within months, simultaneous removal of the vitreous in diabetic eyes appears to reduce the need for re–injections of triamcinolone.
This PDF is available to Subscribers Only