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S.P. Kresovsky, C. Springs, M. Rothbaum; The Effect of 24 Hour Exposure of Preserved and Preservative–Free Triamcinolone on Corneal Endothelial Cells . Invest. Ophthalmol. Vis. Sci. 2006;47(13):75.
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Triamcinolone is frequently used to visualize prolapsed vitreous during anterior segment surgery. However, the question of corneal endothelial toxicity to has yet to be determined. In prior short exposure studies, toxicity was not observed with triamcinolone with benzyl alcohol preservative, the commercially available preparation, and without preservative. However, evaluation of more physiologic longer term exposure to the potential toxins has not been performed. This study compares the effect of 24 hour exposure of corneal endothelium to preserved and preservative–free triamcinolone.
6 corneas deemed unsuitable for corneal transplantation were evaluated. Cell counts and specular microscopy were performed on the corneas prior to treatment. Approximately 1 ml triamcinolone with benzyl alcohol preservative (40mg/ml) was placed on two of the corneal endothelia. The same amount of preservative free triamcinolone was placed on the paired corneal endothelia from the respective donor. Two corneas were treated with balanced salt solution as controls. All of the corneas were refrigerated with their respective treatment on the corneal endothelium for 24 hours, at which time the corneas were rinsed by placing in a vial with balanced salt solution. Cell counts and specular microscopy were repeated after treatment.
One of the corneas treated with preserved triamcinolone and one cornea treated with preservative–free triamcinolone showed no significant change in endothelial cell count. A control cornea also found no significant difference in endothelial cell count. However, two of the treated corneas could not be evaluated with cell count, secondary to drying. One of the control corneas had a slight decrease in endothelial cell count.
After 24 hours of exposure to the preserved and preservative–free triamcinolone, endothelial cell counts were not statistically altered in two corneas suggesting a lack of toxicity. The prior study of the same triamcinolone preparations also revealed minimal toxicity to the corneal endothelium after 5 minutes of exposure. These results support the use of triamcinolone in the anterior chamber with minimal effect on corneal endothelium.
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