Purchase this article with an account.
M. Rothbaum, C. Springs; The Effect of Preserved and Preservative–Free Triamcinolone on Corneal Endothelial Cells . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4522.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: Inadequate removal of prolapsed vitreous during anterior segment surgery is associated with significant ocular morbidity. However, visualization of vitreous can be difficult. Triamcinolone injected into the anterior segment becomes trapped in prolapsed vitreous aiding vitreous visualization. Commercially available triamcinolone is preserved with benzyl alcohol which may be toxic to the corneal endothelium. This study compares the effect on corneal endothelium of triamcinolone with benzyl alcohol preservative and preservative–free triamcinolone. Methods: 12 corneas deemed unsuitable for corneal transplantation were evaluated. Most corneas were paired from the same donor. Cell counts and specular microscopy were performed on the specimens prior to treatment with triamcinolone. A drop of triamcinolone(40mg/ml) with preservative was placed on the endothelium of one of the corneas (n=5) and a drop of triamcinolone without preservative was placed on the other cornea (n=5). 2 corneas served as controls and a drop of balanced salt solution was placed on the corneal endothelium. Triamcinolone or balanced salt solution were left on the corneal endothelium for 5 minutes at which time it was rinsed by placing the cornea in a container with Optisol GStm storage media. Specular microscopy and cell counts were then performed on the treated corneas. Results:All groups showed corneal endothelial toxicity. Cell counts were reduced in all groups and cellular architecture was distorted. However, the control and preservative–free triamcinolone groups showed less corneal toxicity than the preserved triamcinolone group. Some corneas in the preserved triamcinolone group were so badly damaged that no viable cells could be identified and cell counts were unable to be performed. Conclusions: Triamcinolone suspensions with and without preservative showed endothelial toxicity in donor cornea tissue. The toxicity was greater with the triamcinolone containing preservative. This result may be due to the direct toxic effect of the benzyl alcohol preservative or the acidic pH of the preservative. Preservative–free triamcinolone and control corneas showed less corneal endothelial toxicity.
This PDF is available to Subscribers Only