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ABSTRACT.Purpose: To investigate the changes in the aqueous levels of various cytokines after intravitreal triamcinolone or bevacizumab for branch retinal vein occlusion (BRVO). Methods: Twenty-four eyes with macular oedema associated with BRVO and six eyes of six patients undergoing cataract surgery participated in this study. Each patient with BRVO randomly received an intravitreal injection of either 4 mg triamcinolone or 1.25 mg bevacizumab. Aqueous samples were obtained before and 4 weeks after the intravitreal injection in the BRVO group and before surgery in the control group. Aqueous concentrations of 16 cytokines were measured via multiplex bead assay. Results: Prior to the administration of the drugs, aqueous levels of interleukin (IL)-6, IL-8, IL-17 and vascular endothelial growth factor (VEGF) were significantly higher in the BRVO group than in the control group (p = 0.044, p = 0.013, p < 0.001, and p = 0.008, respectively). Between the control group and the BRVO group, no significant differences were noted between pre-and postinjection best-corrected visual acuity (p = 0.60, p = 0.54) and central foveal thickness (p = 0.47, p = 0.82). In the triamcinolone group, levels of IL-6, IL-17, IP-10, platelet-derived growth factor (PDGF)-AA and VEGF were reduced significantly (p = 0.012, p < 0.001, p < 0.001, p = 0.015, and p < 0.001, respectively). But in bevacizumab group, only VEGF was significantly reduced (p < 0.001). Between the IVTA group and the IVBe group, no significant differences in the changes in VEGF levels were noted (p = 0.06). Conclusion: Triamcinolone injection reduces plural inflammatory cytokines in BRVO, while bevacizumab has no influence on other cytokines as selective anti-VEGF therapy. No differences in the therapeutic effect were noted between an inhibition of plural inflammatory cytokines and an inhibition of VEGF only.

Combined 23-gauge sutureless vitrectomy and clear corneal phacoemulsification in patients with proliferative diabetic retinopathy was safe and effective. It may have not only the known advantages of conventional combined surgery but also additionally those such as faster visual rehabilitation and less conjunctival fibrosis.

Purpose: To compare the effect of volumes used in sub- Tenon’s anesthesia on efficacy and intraocular pressure (IOP) in vitreoretinal surgery. Methods: A prospective clinical trial was conducted on patients undergoing sub-Tenon’s anesthesia for vitreoretinal surgery. Patients were randomized to receive either 3-, 5- or 7-ml volumes of anesthetic solution. IOP were measured immediately prior to injection, immediately after injection and at 2, 5 and 10 min after injection. Pain scores were assigned using a numerical visual analogue scale immediately after surgery, and again on postoperative day 1. Results: A total of 108 patients (119 eyes) were studied, including 35 eyes in the 3-ml group, 48 eyes in the 5-ml group, and 36 eyes in the 7-ml group. There were significant elevations in mean IOP following injection in all groups, and a trend for larger rises in IOP with larger volumes of anesthesia (p < 0.01). Mean IOP were elevated after injection, and reduced at all time intervals. However, the reduction in the 3-ml group took levels to preinjection amounts. There were no significant differences in patient-reported pain scores among the groups when assessed immediately after surgery or on postoperative day 1. The incidence of chemosis and high IOP elevations (≥40 mm Hg) were more frequent in the 7-ml group (p < 0.05). Conclusions: Sub-Tenon’s anesthesia is effective in vitreoretinal surgery. It would appear that a 3–5-ml volume of anesthetic is safe, when considering the associated complications.

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