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T. S. Mendes, M. M. Freitag, V. M. Sakata, K. Kiefer, S. Abujamra, A. M. V. Gomes; Adjunctive Intraocular Triamcinolone Acetonide in Vitreoretinal Surgery for Retinal Detahment With Proliferative Vitreoretinopathy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):6077.
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To evaluate the preventive effect of adjunctive intraocular triamcinolone acetonide (TA) in vitreoretinal surgery for retinal detachment with proliferative vitreoretinopathy (PVR).
Twenty-nine eyes with rhegmatogenous retinal detachment that underwent vitrectomy combined with silicone oil were included. The Fisher test was performed to verify the association between reoperation rate and adjunctive intraocular triamcinolone for both groups (triamcinolone and control group) and comparative data was obtained. The medium postoperative visual acuity was analyzed by Mann-Whitney test, because of the non-measured values >1.3 LogMAR. The preoperative presence of PVR was classified in absent PVR; PVR grade B; PVR grade C1-C2; PVR C3 and PVR grade D1-D2.
Retinal reattachment without any reoperation was achieved in 92,9% and 66,7% in the adjunctive triancinolone group and control group, respectively, after 24 months. No statistically significant difference was observed between the two groups in terms of secondary outcome measures (preoperative visual acuity and preoperative grade of PVR). In the group of patients who received intraocular triamcinolone, only one eye needed reoperation (7,4%) and in the control group, five patients were reoperated (33,3%). An association between postoperative PVR and reoperation rate was found in the control group (p=0,0020). The mean preoperative visual acuity was >1.3 logMAR in both groups. The postoperative visual acuity improved in all patients with a medium of 0.84 logMAR. No association was found between preoperative PVR and reoperation rate for both groups. In the triamcinolone group, 35,7% of the patients was classified as PVR grade D1-D2 and in the control group 6,7%. Besides the increased chance of patients with PVR grade D1-D2 in developing postoperative PVR, just one patient of the triamcinolone group with preoperative PVR needed reoperation (7,4%).
The triamcinolone acetonide injection combined with silicone oil may prevent the postoperative PVR and decrease the rate of reoperation.
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