Early Postoperative Changes Following Vitrectomy With Intravitreal Injection of Triamcinolone for Diabetic Macular Edema

Abstract

Abstract: : Purpose: To determine the efficacy of pars plana vitrectomy (PPV) with an intravitreal injection of treamcinolone acetonide (TA) in eyes with diabetic macular edema (DME). Methods: A posterior vitreous detachment was created during PPV in 32 eyes of 30 patients with DME. At the end of vitrectomy, 4 mg of TA was injected intravitreally in 22 eyes (TA group) and not injected in 10 eyes (no–TA group). The best–corrected visual acuity (BCVA) in logMAR units and OCT–determined foveal thickness were examined before, and 1 and 3 months after surgery. Results: The mean BCVA improved significantly in the TA group at 1 month (P=0.02) and 3 months (P=0.01) postoperatively. The mean BCVA in the no–TA group gradually improved postoperatively, but was not significantly better at 3 months (P=0.37). The mean foveal thickness decreased markedly after surgery in both the TA and no–TA group. At 1 month postoperatively, the mean foveal thickness was significantly thinner in the TA eyes than in the no–TA eyes (P=0.04), however, there was no significant difference between two groups at 3 months. A recurrence of macular edema was observed in 4 TA eyes and in 2 no–TA eyes. Conclusions: An intravitreal injection of TA after PPV may speed up the resolution of DME. The complete visual recovery after vitrectomy for DME reportedly takes more than 6 months, therefore, further careful observations should be made to determine the additional benefit of simultaneous intravitreal injection of TA.

Keywords: diabetic retinopathy • drug toxicity/drug effects • topography