Abstract
Abstract: :
Purpose: To study the effect of posterior subtenon injection of triamcinolone acetonide (TA) combined with vitrectomy for diabetic macular edema (DME). Methods: Forty–three eyes of 43 patients with DME underwent vitrectomy, and were followed for more than 6 months. Twently–two eyes (group A) were randomly selected as the eyes with posterior subtenon injection of TA (20 mg) immediately after vitrectomy. In 21 eyes of group B, vitrectomy was performed without TA injection. Visual acuity, foveal thickness (FT) determined by optical coherence tomography, intraocular pressure (IOP), and blood glucose level (BGL) were repeatedly measured. Results: The visual acuity improved in group A at 1 month after surgery (0.03–0.5 to 0.06–0.7), while the visual acuity did not change in group B (0.05–0.5 to 0.05–0.6). The visual acuity in both groups improved at 6 month after surgery, and no difference was found between the 2 groups (group A: 0.07–0.7, group B: 0.06–0.8). The FT was decreased in both groups after surgery, and the FT in group A (274 ± 84 mm) was significantly less than that in group B (319 ± 77 mm) at 1 month (P = 0.02). In group A, the IOP at 1 week after surgery (15.9 ± 4.5 mmHg) was significantly higher than the preoperative IOP (13.6 ± 2.5 mmHg) (P = 0.02). The BGL in group A at 1 week after surgery tended to be higher than the preoperative BGL (P = 0.06). Conclusions: Intraoperative posterior sub–Tenon injection of TA may be useful to decrease macular edema and to improve visual acuity within 1 month after vitrectomy in eyes with DME. However, intraoperative TA injection may increase IOP and BGL.
Keywords: diabetic retinopathy • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • diabetes