Abstract
Purpose::
With expansion of indications for vitrectomy, its use for macular edema and uveitis has increased recently. However, there have been reports that vitrectomy itself causes inflammation. Therefore, we investigated the effect of simple vitrectomy with 25-gauge system, less-invasive surgical technique, in the rabbits. We also investigated the efficacy of intravitreal administration of triamcinolone acetonide (TA) immediately after surgery.
Methods::
Simple vitrectomy was performed on the anesthetized male Dutch rabbit using the following conditions: two 25-gauge ports, cutting rate 1000 cuts/min, suction 200 mmHg, suction time 1 minute. TA 1.2 mg/30µL/eye (suspension) was injected into the vitreous body immediately after surgery. A saline treatment group was set up as a control. Measurement of protein concentration in the vitreous body and aqueous humor was performed on postoperative days 1, 4, and 7, and follow-up observation was carried out by fundus photography.
Results::
Vitreous protein concentration in the saline treatment group (15.2±2.0 mg/mL) rose markedly on postoperative day 1 as a result of simple vitrectomy compared with the untreated group (0.3±0.05 mg/mL). Similarly, a marked increase in aqueous protein concentration was seen in treated eyes (15.6±11.3 mg/mL) compared with untreated eyes (0.8±0.1 mg/mL). Vitreous protein concentration was also significantly high on postoperative day 7 in treated eyes (7.3±2.1 mg/mL) compared with untreated eyes (p<0.01). Intravitreal injection of TA immediately after vitrectomy did not exhibit an inhibitory effect on these increases.
Conclusions::
It strongly suggests that simple vitrectomy causes inflammation of the anterior and posterior segments of the eye. Intravitreal injection of TA immediately after vitrectomy did not exhibit an inhibitory effect on the rise in vitreous and aqueous protein concentration associated with this postoperative inflammation. Therefore, postoperative inflammation needs to be adequately considered when performing vitrectomy and during postoperative management.
Keywords: inflammation • vitreoretinal surgery • aqueous