Abstract
Abstract: :
Background: Triamcinolone acetonide (TA) is widely used as an aid in visualizing the vitreous body during vitrectomy. However, intravitreal injection of TA would be a cause of ocular hypertension, cataract, and endophthalmitis. Purpose: To develop a new technique of visualizing the vitreous body using 11–deoxycortisol (11–DC), a precursor of cortisol without steroid activity. Methods: To investigate the clinical usefulness of 11–DC, vitrectomy was performed in enucleated pig eyes. To investigate the safety of 11–DC, 4 mg of 11–DC dissolved in BSS, 4 mg of TA in BSS, or BSS alone was injected in the vitreous body of white rabbits (n = 8 in each group). Intraocular pressure, electroretinogram, retinal findings and retinal histology were examined for 4 weeks after injection. Results: After 11–DC injection, the white particles of 11–DC were entrapped on the surface of the vitreous body, making the vitreous gel clearly visible. This technique of visualizing the vitreous body greatly facilitated the surgical procedure of vitrectomy. Intravitreal injection of 11–DC had no significant influence on intraocular pressure, the b–wave amplitude of electroretinogram, retinal findings, and histological findings of the retina. In contrast, four weeks after the injection of TA, the intraocular pressure had significantly increased by about 30% compared with that of BSS alone. Conclusions: 11–deoxycortisol, a precursor of cortisol in the cascade of steroid metabolism, had no glucocorticoid or mineralcorticoid activities. The suspension of 11–deoxycortisol can be used safely and effectively as an aid in visualizing the vitreous body without any complications.
Keywords: vitreoretinal surgery