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J. F. Payne, C. Bergstrom, S. K. Srivastava; Residual Triamcinolone Acetonide Sequestered in the Fovea After Macular Hole Repair: Outcomes of Surgery. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4453.
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To report the macular hole closure rate and visual outcomes of patients with residual triamcinolone acetonide (TA) on the fovea following pars plana vitrectomy with internal limiting membrane (ILM) peeling.
We reviewed the medical records of patients who underwent a triamcinolone-assisted pars plana vitrectomy and ILM peeling for a macular hole between 2005 and 2008 at our institution. Preservative-free TA was used intraoperatively to enhance the visualization of the vitreous in all patients. One patient received an additional injection of TA at the end of the surgery to treat postoperative inflammation. Patients with residual TA on the fovea at any immediate postoperative visit were included for analysis.
A total of six patients were included. All patients had either stage III or IV macular holes, and the median preoperative best corrected visual acuity (BCVA) was 20/200. Three patients experienced an increase in intraocular pressure postoperatively, which was able to be controlled with topical glaucoma agents. The mean follow-up time was 14 months (range, 3.3 to 35.4 months), and the median BCVA at last follow-up was 20/40. Each patient experienced an improvement in BCVA after surgery, with an average of 5.2 lines gained at last follow-up. Anatomical hole closure, which was determined by slit lamp biomicroscopy and confirmed with optical coherence tomography was achieved in every patient.
Residual triamcinolone acetonide sequestered in the fovea following macular hole surgery does not appear to affect hole closure or prevent improvement in visual acuity.
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