Adjunctive Intravitreal Triamcinolone Acetonide Injection at the End of a Sutureless Phacovitrectomy for Diabetic Vitreous Hemorrhage

Abstract

Purpose: This study aims to evaluate the visual outcome, clinical outcome and complications of intravitreal triamcinolone acetonide (IVT) injections at the end of a sutureless 23 G phacovitrectomy in diabetic patients with vitreous hemorrhage. Methods: This is a prospective comparative case study comprising 22 eyes that underwent a 23 G sutureless phacovitrectomy for diabetic vitreous hemorrhage (VH) with or without tractional retinal detachment (TRD). An IVT (4 mg/0.1 ml) injection was performed on 11 eyes at the end of the vitrectomy, and no injection was administered in 11 eyes. The main outcome measures included best-corrected visual acuity (BCVA), intraocular pressure (IOP), and incidence of postoperative VH and reoperation in patients with at least three months of follow-up. Results: Early postoperative VH within one month occurred in (9.1%) of the IVT group and in (27.27%) of the control group. The rate of early postoperative VH was significantly reduced in the IVT group compared to the control group (p=0.006). Late postoperative VH after one month occurred in (18.18%) of the IVT group and in (27.27%) of the control group. No difference was noticed between the two groups (p=0.341). No difference in BCVA was noticed between the two groups at three ms (p>0.05). In the IVT group, The IOP on postoperative day 1 was higher than preoperative IOP (p=0.003). No significant difference in the rate of reoperation was noted between the two groups (p=0.285). Conclusions: Adjunctive IVT injections in diabetic phacovitrectomy reduced early postoperative VH; however, it did not affect the final visual outcome.