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H. F. Fine, L. Vannozzi, M. Engelbert, S. Chang; Epiretinal Membrane Peeling With and Without Intraoperative Triamcinolone Acetonide Assistance. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4135.
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Triamcinolone acetonide assistance (TAA) is helpful for improved intraoperative epiretinal membrane (ERM) visualization. The purpose of this study was to compare the visual outcomes of patients who underwent ERM peeling with and without TAA. Secondary outcomes included macular thickness, as measured on optical coherence tomography (OCT), and adverse events.
This study is a retrospective comparative interventional case series. Consecutive patients who underwent ERM peeling by a single surgeon at a single site were included. Patients who had concomitant macular disease that could affect visual outcome were excluded. Best corrected visual acuity was recorded pre-operatively and at months 1 and 3.
94 consecutive patients were identified who underwent ERM peeling; 81 were included and 13 were excluded. The mean age was 67 years. Mean acuity improved preoperatively to month 1 to month 3 with TAA: 20/65 to 20/47 (p=0.0008) to 20/38 (p<0.0001); and without TAA: 20/59 to 20/42 (p=0.0060) to 20/39 (p=0.0010). There was no statistical difference in 3-month visual (p=0.34) or OCT outcome (p=0.56) with TAA. Those patients who underwent concomitant phacoemulsification and intraocular lens placement had a statistically improved visual outcome compared with those who did not (p = 0.05). Two patients had hypotony with an intraocular pressure below 6 mm Hg on post-operative day 1 despite beveled 25-gauge sclerotomies. No other adverse events were noted.
Visual outcomes were significantly improved at months 1 and 3 after ERM peeling both with and without TAA. TAA resulted in statistically similar visual and OCT outcomes without an increase in adverse events. Therefore, in this retrospective comparative case series, intraoperative TAA appeared safe and effective for ERM peeling.
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