Triamcinolone Acetonide in Silicone-Filled Eyes as Adjunctive Treatment for Proliferative Vitreoretinopathy: A Randomized Clinical Trial

Abstract

To evaluate the effect of adjunctive intraocular triamcinolone acetonide (TA) in silicone-filled eyes on outcomes of vitreoretinal surgery for proliferative vitreoretinopathy (PVR). Prospective, randomized, controlled clinical trial. Seventy-five eyes with rhegmatogenous retinal detachment and PVR grade C (posterior, anterior, or both) undergoing vitrectomy combined with silicone oil tamponade were included. Of these, 38 eyes were assigned randomly to the adjunctive treatment, whereas 37 eyes served as controls. All eyes underwent pars plana vitrectomy, membrane peeling, and silicone oil exchange, with or without relaxing retinotomy or retinectomy. In the treatment group, 4 mg TA was injected into the silicone-filled vitreous cavity at the end of the procedure. Silicone oil was removed 3 months after surgery in eyes with attached retinas. The primary outcome measure was retinal reattachment rate at 6 months. Secondary outcome measures included visual acuity, rate of recurrent PVR, reoperation rate, and rise of intraocular pressure. Retinal reattachment without any reoperation was achieved in 32 eyes (84.2%) and 29 eyes (78.4%) in the adjunctive treatment and control groups, respectively, at 6 months (P = 0.5). No statistically significant difference was observed between the 2 groups in terms of any of the secondary outcome measures (P>0.05). The outcomes of vitreoretinal surgery for established PVR are not improved significantly by adjunctive TA injection in silicone-filled eyes.