June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Using Intraoperative Triamcinolone Acetonide Irrigation to Reduce Post-Operative Pain from Scleral Buckle Surgery
Author Affiliations & Notes
  • Parth Vaidya
    Virginia Tech Carilion School of Medicine, Roanoke, Virginia, United States
  • Romulo Albuquerque
    Retina, Vistar Eye Center, Roanoke, Virginia, United States
  • Micheal McClintock Jr
    Retina, Vistar Eye Center, Roanoke, Virginia, United States
  • Vishak John
    Virginia Tech Carilion School of Medicine, Roanoke, Virginia, United States
    Retina, Vistar Eye Center, Roanoke, Virginia, United States
  • Footnotes
    Commercial Relationships   Parth Vaidya, None; Romulo Albuquerque, None; Micheal McClintock Jr, None; Vishak John, None
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 3089. doi:
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      Parth Vaidya, Romulo Albuquerque, Micheal McClintock Jr, Vishak John; Using Intraoperative Triamcinolone Acetonide Irrigation to Reduce Post-Operative Pain from Scleral Buckle Surgery. Invest. Ophthalmol. Vis. Sci. 2021;62(8):3089.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Scleral buckle surgery is a widely used ophthalmic surgery for the correction of rhegmatogenous retinal detachment. Studies suggest that eye pain is a common and underestimated occurrence after scleral buckle surgery, but as of yet, there is no definitive management method for reducing pain following scleral buckle surgery. We aim to control pain following scleral buckle surgery with sub-tenon irrigation with triamcinolone acetonide at the time of surgery. Using a randomized prospective clinical study, we test if this technique will reduce the pain, nausea/vomiting, and analgesic use caused by scleral buckle surgery.

Methods : Forty-eight patients undergoing scleral buckle surgery will be randomized into two groups. The experimental group receives a sub-tenon irrigation of 1 cc 40mg/mL triamcinolone acetonide around the base of the scleral buckle (0.25 cc in each quadrant) at time of operation. The control group does not receive any triamcinolone irrigation. Pain scores are measured 1 day post-operatively via 11-pt numerical rating scale as the primary outcome. The nausea/vomiting score is measured 1 day post-operatively via standard 6-pt scale. Patients track pain medication use via pill count. Values will be measured again at 1-2-week and 6 months post-op.

Results : With 13 patients enrolled, pain was reduced in the experimental group at one day (x = 2.2 vs 1.1) and one week post-operatively (x = 0.8 vs 0.0), though the difference is not statistically significant (p = 0.23 and 0.099 respectively). Acetaminophen use was not significantly different between the groups (x =3125, 2750 mg, p= 0.85), nor was ibuprofen use (x= 600, 683 mg, p= 0.9). The nausea/vomiting score was not significantly different between the groups (x =0.2, 0.11, p= 0.6). Not enough patients have reached the 6-month time point for statistical analysis.

Conclusions : Though it is not statistically significant at this time, there is a measurable decrease in median pain score between the control and experimental group at both 1 day and 1 week post-op. We are optimistic this will trend towards significance as we continue to enroll patients. No significant differences or trends could be established with the nausea/vomiting score or analgesic use. This study shows that sub-tenon irrigation of triamcinolone acetonide at the time of scleral buckle surgery may be a promising method for reducing post-operative pain.

This is a 2021 ARVO Annual Meeting abstract.

 

 

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