Abstract
Purpose: :
Silicone oil is a widely used tamponade agent during vitrectomy for complicated retinal surgery. Intravitreal triamcinolone injection is a well-accepted method for treatment of cystoid macular edema. Here we report intravitreal injection of triamcinolone in vitrectomized, silicone oil filled eyes for treatment of cystoid macular edema.
Methods: :
Two eyes from 2 patients with recurrent retinal detachment underwent vitrectomy with silicone oil for tamponade. Retinal detachments were repaired successfully. However, cystoid macular edema (CME) developed with decreased vision. Intravitreal triamcinolone (4 mg) injection was performed in these silicone oil filled eyes for the treatment of CME. Patient vision before and after triamcinolone injection were recorded, and the central macular thickness were measured with OCT.
Results: :
Immediately after intravitreal injection, the triamcinolone appeared as a dome shaped pellet located in the silicone oil inferiorly. It then dissipated, and not visible 1 week after injection. In one eye, vision improved from 20/400 to 20/150, and central macular thickness decreased from 500 um to 240 um 3 weeks after triamcinolone injection. The second eye vision improved from finger count to 20/400, and foveal thickness from 830 um to 510 um in 2 weeks. In two months, cystoid macular edema returned in these two eyes, and one eye received repeat injection with good result. No side effect, such as intraocular pressure spike or endophthalmitis, was observed.
Conclusions: :
When cystoid macular edema develops in eyes filled with silicone oil, intravitreal triamcinolone injection could be considered as an option for treatment of cystoid macular edema.
Keywords: edema • injection • vitreoretinal surgery