Does intravitreal triamcinolone acetonide-assisted peeling of the internal limiting membrane effect the outcome of macular hole surgery?

Karaçorlu, Murat; Özdemir, Hakan; Karacorlu, Serra

doi:10.1007/s00417-005-1133-x

Cited by 30 publications

(23 citation statements)

References 18 publications

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“…In several studies, intraocular TA was used intraoperatively during pars plana vitrectomy to visualize the inner limiting membrane, epiretinal membranes and remnants of the vitreous base [207,214,219,220,236]. Yamamoto et al [216] found that using TA during vitrectomy may facilitate both the removal of the epiretinal membrane around the macular hole and the separation of the residual vitreous cortex from the retina in highly myopic eyes with retinal detachment.…”

Section: Clinical Studies: Ta As Medical Device (Vitrectomy)mentioning

confidence: 99%

Intravitreal Triamcinolone

Tao

Jonas

2010

Ophthalmologica

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Background: To provide an update on the intravitreal use of triamcinolone acetonide. Methods: Review of literature regarding triamcinolone-related research. Results: After the introduction of bevacizumab and ranibizumab into clinical practice, intravitreal triamcinolone has lost its leading position as the drug most often injected intravitreally. Due to its properties as a long-acting steroid, triamcinolone has still been used for various conditions such as diffuse diabetic macular edema, retinal vein occlusions, pseudophakic cystoid macular edema, chronic prephthisical ocular hypotony and uveitis, and in combination with bevacizumab or ranibizumab. The complications of intravitreal triamcinolone therapy include secondary ocular hypertension in about 40% of the eyes injected, cataract and postoperative infectious or noninfectious endophthalmitis. Conclusions: Due to its widespread biological effects as a steroid and due to a relatively large therapeutic window, intravitreal triamcinolone has remained in clinical use for a variety of intraocular disorders, and it may be a promising candidate for intravitreal medical combination therapies.

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Section: Clinical Studies: Ta As Medical Device (Vitrectomy)mentioning

confidence: 99%

Intravitreal Triamcinolone

Tao

Jonas

2010

Ophthalmologica

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“…Kimura et al [198] performed triamcinolone acetonide-assisted peeling of the internal limiting membrane [122,203,204] . Yamamoto et al [200] used intravitreal triamcinolone acetonide in 6 eyes during vitrectomy in highly myopic eyes with retinal detachment due to a macular hole.…”

Section: Pars Plana Vitrectomy Combined With Intravitreal Triamcinolomentioning

confidence: 99%

Intravitreal Triamcinolone Acetonide: A Change in a Paradigm

Jonas¹

2006

Ophthalmic Res

149

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Background: Based on experimental studies and clinical observations by Robert Machemer, Gholam Peyman and others, the vitreous cavity has increasingly been used as a reservoir of drugs for the direct treatment of intraocular diseases. Methods and Results: The most widely injected drug so far has been triamcinolone acetonide for various intraocular neovascular and edematous diseases. Comparing the various diseases with respect to effect and side effects of the treatment, the best response in terms of gain in visual acuity has been achieved for intraretinal edematous diseases such as diffuse diabetic macular edema, branch retinal vein occlusion, central retinal vein occlusion, and pseudophakic cystoid macular edema. In eyes with various types of noninfectious uveitis including acute or chronic sympathetic ophthalmia and Adamantiadis-Behçet’s disease, visual acuity increased and the degree of intraocular inflammation decreased. Some studies have suggested that intra- vitreal triamcinolone may be useful as an angiostatic agent in eyes with iris neovascularization and proliferative ischemic retinopathies. Intravitreal triamcinolone may possibly be helpful as adjunct therapy for exudative age-related macular degeneration, particularly in combination with photodynamic therapy. In eyes with chronic, therapy-resistant ocular hypotony, intravitreal triamcinolone can induce an increase in intraocular pressure and may stabilize the eye. The complications of intravitreal triamcinolone therapy include secondary ocular hypertension in about 40% of the eyes injected; medically uncontrollable high intraocular pressure leading to antiglaucomatous surgery in about 1–2% of the eyes; posterior subcapsular cataract and nuclear cataract leading to cataract surgery in about 15–20% in elderly patients within 1 year after injection; postoperative infectious endophthalmitis with a rate of about 1:1,000; noninfectious endophthalmitis, perhaps due to a reaction to the solvent agent, and pseudoendophthalmitis with triamcinolone acetonide crystals appearing in the anterior chamber. Intravitreal triamcinolone injection can be combined with other types of intraocular surgery including cataract surgery, particularly in eyes with iris neovascularization. Cataract surgery performed some months after the injection does not show a markedly elevated complication rate. The injection may be repeated, if vision redecreases. In nonvitrectomized eyes, the duration of the effect and side effects of a single intravitreal injection of triamcinolone is about 6–9 months for a dosage of about 20 mg, and about 2–4 months for a dosage of 4 mg. It has remained unclear so far, whether and how to remove the solvent agent. In the future, intravitreal triamcinolone may be combined with other antiangiogenic drugs for the treatment of exudative age-related macular degeneration or with neuroprotective drugs for treatment of diabetic retinopathy. Conclusions: Despite an exponentially increasing number of mostly case-series studies, the intravitreal injection of triamcinolo...

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“…(2,8) Since then other studies have confirmed that TA-assisted ILM removal gives good results (figure 7D) (39)(40)(41) . Compared to ICG-guided ILM removal, a noncontrolled study indicates that TA has the same closure rate with significantly better visual results with no side effects (42) . Crystals of TA have been detected up until forty days post surgery with chromovitrectomy for MH surgery.…”

Section: Triamcinolone Acetonidementioning

confidence: 99%

State of the art in chromovitrectomy

Caiado¹,

Moraes-Filho²,

Maia³

et al. 2014

Revista Brasileira De Oftalmologia

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Vitrectomy is a surgery that involves complex and delicate techniques that treat diseases such as macular hole, epiretinal membrane and diabetic macular edema. Chromovitrectomy is one of these techniques and includes the use of coloring agents such as vital dyes or crystals to enhanced visibility of transparent structures during vitrectomy. The aim of this study was to present a modern approach, based on scientific evidence, about the application and indication of vital coloring agents during vitrectomy. The use of such agents has made this surgery more predictable and has increased its post-operative prognosis. Although research on chromovitrectomy is currently expanding there is still not an established gold standard dyeing agent.Keywords: Vitrectomy; Vitreous body; Macular hole; Retina; Dyeing agents; Epiretinal membrane RESUMOA cirurgia vitreorretiniana é uma cirurgia que envolve técnicas complexas e delicadas que tratam doenças como buraco macular, membrana epirretiniana e o edema macular diabético. A cromovitrectomia é uma dessas técnicas que incluem o uso de corantes compostos de pigmentos vitais ou cristais para melhorar a visibilização de estruturas transparentes durante a cirurgia de vitrectomia. O objetivo desse artigo foi apresentar uma abordagem atual, baseada em evidências, sobre a aplicação e indicação de corantes vitais durante a cirurgia vitreorretiniana. O emprego desses corantes possibilitou uma maior previsibilidade para a cirurgia, melhorando assim seu prognóstico pós-operatório. Apesar do campo da cromovitrectomia está em plena expansão de pesquisas, um corante gold standard para cromovitrectomia ainda não está estabelecido.

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Does intravitreal triamcinolone acetonide-assisted peeling of the internal limiting membrane effect the outcome of macular hole surgery?

Cited by 30 publications

References 18 publications

Intravitreal Triamcinolone

Intravitreal Triamcinolone

Intravitreal Triamcinolone Acetonide: A Change in a Paradigm

State of the art in chromovitrectomy

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