Vitrectomy combined with intraviteal injection of half-dose triamcinolone acetonide for proliferative diabetic retinopathy

Abstract

Objective To investigate the efficacy and safety of pars plana vitrectomy (PPV) combined with intraviteal injection of half-dose triamcinolone acetonide (TA) for proliferative diabetic retinopathy (PDR). Methods Thirty-nine eyes of 32 patients with PDR accepted PPV combined with intraviteal injection of half-dose TA (2 mg/0.05 ml). And membrane peeling, retinal photocoagulation, scleral cryocoagulation, silicone oil or C3F8 gas tamponade were applied according to particular situation respectively. The visual acuity, intraocular pressure (IOP), inflammatory reaction of anterior chamber, lens opacification, vitreoretinal hemorrhage and detachment of retina were observed and analyzed after the procedure. Results Postoperative following up was 3~18 months, with average (7.81±4.52) months. The visual acuity was improved in 36 eyes (92.31%), and the difference was statistically significant between the preoperative one and the postoperative one (Z=-5.539, P=3.03×10-8). The difference between the preoperative IOP and the postoperative IOP 3rd month postoperatively was not statistically significant (t=-0.204, P=0.84). Transient postoperative elevated IOP occurred in 8 eyes(20.51%) in two weeks after surgery. All cases had mild inflammatory reaction of anterior chamber. Cataract appeared in 8 eyes (20.51%). And retinal detachment occurred in 2 eyes (5.13%). Conclusion PPV combined with intraviteal injection of half-dose TA is safe and effective for the treatment of PDR. It could control inflammation and improve visual acuity with few serious complications. Key words: Retinopathy, diabetic, proliferative; Vitrectomy; Triamcinolone acetonide, half-dose