Triamcinolone-assisted 3D-vitrectomy in diabetic vitreomacular traction

Abstract

Purpose:To evaluate the efficacy of triamcinolone as an aid in vitreous visualization during 3D-vitrectomy for the treatment of diabetic vitreomacular traction. Methods: Prospective interventional study in patients with symptomatic vitreomacular traction. Pre-and postoperative assessments included visual acuity, retinography, intraocular pressure and optical coherence tomography. All patients were operated by the same surgeon (OOMJ). Triamcinolone was used as a visual enhancer during surgery. The parameters of the vitreophage (Accurus 800CS, Alcon) were set to the 3D-system (dual dynamic drive), contact lenses (plain and wide angle) being used for visualization. Peripheral 360º vitreous circumcision at high cut rate was performed, carefully releasing the vitreomacular adhesion at the posterior pole by means of an appropriate pic or vitreoretinal forceps. Results: The sample consisted of five consecutive patients (five eyes), three female and two male, with symptomatic vitreomacular traction. Their age ranged from 54 to 71 years (mean 62.6 ± 6.3 years). During the surgical procedure, the areas with vitreomacular traction were properly visualized and identified after the application of triamcinolone. No complications were recorded during or after surgery. There was a statistically significant improvement in visual acuity after the surgical procedure (p=0.0313). Conclusion: Triamcinolone facilitates the surgical treatment of vitreomacular traction by improving visibility of both the vitreous humor and the vitreous-retina interface. Triamcinolone-assisted 3D vitrectomy proved to be an effective procedure in these cases. ABSTRACT INTRODUCTION

Perfluorocarbon-perfused 23 gauge three-dimensional vitrectomy for complicated diabetic tractional retinal detachment

“…In about 5%–10% of cases, proliferative vitreoretinopathy develops and complicates the anatomical and functional prognosis 4,5. Despite advances in surgical instrumentation and techniques, management of advanced cases of tractional retinal detachment, with or without proliferative vitreoretinopathy, continues to demand a mixture of surgical skill, experience, and good judgment 6,7…”