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W.M. Munir, J.S. Pulido, M.C. Sharma, B. Buerk; Intravitreal Triamcinolone Acetonide For the Treatment of Complicated Proliferative Diabetic Retinopathy and Proliferative Vitreoretinopathy . Invest. Ophthalmol. Vis. Sci. 2004;45(13):2062.
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Purpose: To present a retrospective review of the clinical outcome and complications of unaltered intravitreal triamcinolone acetonide injection in conjunction with pars plana vitrectomy and silicone oil injection for the treatment of complicated proliferative diabetic retinopathy and proliferative vitreoretinopathy. Methods: From a computerized patient database, thirteen eyes of twelve consecutive patients who received intravitreal injection of unaltered triamcinolone acetonide in conjunction with pars plana vitrectomy and silicone oil injection for the treatment of complicated proliferative diabetic retinopathy and proliferative vitreoretinopathy were identified. All eyes were operated on by the same surgeon, and received 4mg of unaltered, commercially available triamcinolone acetonide intravitreally, prior to silicone oil injection. The patients were followed for a mean followup time of 4.7 months (range of 1–15 months), and demographic as well as pertinent pre–operative and post–operative clinical information was gathered. Results: At the last followup visit, vision had improved in four eyes, remained stable in five eyes, and worsened in four eyes. The retina was attached at the end of followup in ten of the thirteen eyes. Eight of the thirteen eyes did not show any clinical signs of reproliferation or redetachment during the course of followup. The mean intraocular pressure did not increase (pre–operative IOP of 10.8+/–6.22 mmHg with a range of 0–22 mmHg, last followup IOP of 9.6+/–3.86 mmHg with a cumulative post–operative range of 0–26 mmHg). Steroid crystals were visible at one month post–operatively in three eyes, and did not hinder fundus examination significantly. Conclusion: The intravitreal injection of low dose, unaltered triamcinolone acetonide in the setting of pars plana vitrectomy and silicone oil injection for the treatment of proliferative vitreoretinopathy and complicated proliferative diabetic retinopathy appears to be well tolerated. Further controlled study needs to be done in order to clearly define the potential beneficial effects of intravitreal steroids in these two disease processes.
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