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T Sakamoto, H Enaida, Y Noda, A Ueno, T Nakamura, T Ishibashi; Triamcinolone-assisted Pars Plana Vitrectomy Improves the Surgical Procedures and Decreases the Post-operative Blood-ocular Barrier Breakdown . Invest. Ophthalmol. Vis. Sci. 2002;43(13):651.
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Purpose:to determine the effect of a triamcinolone-assisted pars plana vitrectomy (PPV) on the visibility of hyaloid during surgery and the postoperative clinical findings. Methods:Thirty-one patients with proliferative retinal disease [8 diabetic macular edema (DME), 10 proliferative diabetic retinopathy (PDR), 13 proliferative vitreoretinopathy (PVR)] underwent PPV, where the vitreous body was visualized by the intravitreal injection of triamcinolone solution during the operation. The surgically removed posterior hyaloid cortex was examined electronmicroscopically. The visual acuity, intraocular pressure (IOP), tamponade, corneal pathology, after cataract, vitreous hemorrhage, and re-operation, were thereafter examined for at least for 3 months. The anterior chamber laser flare cell meter was used to examine in DME eyes with triamcinolone-assisted PPV and with routine PPV on day 8 to evaluate the breakdown of the blood ocular barrier. Results:The vitreous body was clearly seen by triamcinolone during surgery, which greatly helped us to perform a posterior hyaloid resection safely and thoroughly. The surgically resected hyaloid consisted of fibriller material and a cellular component. Six of eight DME, 8 of 10 PDR and 5 of 13 PVR eyes showed an improvement in their vision postoperatively. No eye except one experienced uncontrollable IOP elevation. Six eyes had vitreous hemorrhage. The DME eyes which received triamcinolone-assisted PPV showed significantly less breakdown of the blood ocular barrier than those with routine PPV (The Mann-Whitney U-test , P<0.01). Conclusion:Triamcinolone improved the visibility of the hyaloid and the safety of the surgical procedures during PPV and also inhibited the post-operative breakdown of the blood ocular barrier.
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