Abstract
Abstract: :
Purpose: To evaluate the outcome of patients with severe proliferative diabetic retinopathy (PDR) requiring pars plana vitrectomy (PPV) that received combination therapy of intraocular triamcinolone and silicone oil. Methods: A retrospective chart review of patients with severe PDR that underwent PPV from February 2003 to October 2003 was performed. Patients that underwent PPV, extensive membranectomy, endolaser, and silicone oil combined with an injection of 4 mg Triamcinolone were identified. Results: Ten patients (10 eyes) were included in the study. Age ranged from 29 to 56 years. Four were male and 6 female. Type I diabetes was diagnosed in 1 patient, and Type II in 9 patients. Six patients were African American and 4 Caucasians. All eyes had vitreous hemorrhage, extensive membranes, and 9 eyes had previously been treated with panretinal photocoagulation. Follow up ranged from 1 month to 9 months. Preoperative visual acuity ranged from 20/50 to hand motion, with 60% of the eyes measuring count finger or worse. Postoperatively, six eyes (60%) had improvement in visual acuity, 3 eyes (30%) worsened and 1 eye (10%) remained stable. Also, only 4 eyes (40%) remained count finger or worse. Triamcinolone crystals were resolved in 5 eyes at 3 months, however it was noted in 2 eyes at 3 and 5 months. The remaining 3 eyes were seen at 1 month follow–up with crystals. Nine eyes required topical therapy for elevated intraocular pressure after the procedure, with 7 of these patients still requiring intraocular pressure control at last visit. One eye developed retro–silicone oil fibrosis alongside the superior arcade and 1 eye had pre–macular hemorrhage noted 1 day postoperatively Conclusions: Triamcinolone can be used in combination with silicone oil in severe PDR to stabilize blood ocular barrier. The main complication observed was elevated intraocular pressure.
Keywords: diabetic retinopathy