Abstract
Purpose: :
Triamcinolone is currently used as a visualization aid in vitreoretinal surgery. The purpose of the present study is to evaluate its effect on anatomical and functional outcome in retinal detachment surgery
Methods: :
The data base (age, preoperative visual acuity, PVR stage, number of breaks, extension of the detachment, surgical procedure, post-operative visual acuity, recurrence, OCT assessed subretinal fluid persistence) of all patients with retinal detachment was analyzed. Patients undergoing primary vitrectomy, laser, gas tamponade (C3F8) with or without triamcinolone between january 2005 and december 2007 were included in this study.
Results: :
259 patients met the inclusion criteria . The overall recurrence of retinal detachment was 7%. In the group of patients treated with triamcinolone (n=146), the recurrence rate was 10% versus 3% in the group without intra-operative use of triamcinolone (n=113) (CHI2 ; p=0,025). At 3 months, among the patients with no recurrence, the mean visual acuity was 0,49 log MAR, there was no significant difference between the 2 groups. The subretinal fluid persistence was observed more frequently in the triamcinolone group (n=11) than in the group without intraoperative use of triamcinolone (n=1) (CHI2 ; p=0,003).
Conclusions: :
In this retrospective non randomized study, intra-operative use of triamcinolone significantly increased the recurrence rate of retinal detachment. The inhibitory effect of corticosteroids on fluid absorption by the retinal pigment epithelium could explain the persistence of a shallow retinal detachment 3 months post-operatively.
Keywords: retinal detachment • retinal adhesion • corticosteroids