Reduced Incidence of Intraoperative Complications in a Multicenter Controlled Clinical Trial of Triamcinolone in Vitrectomy

Yamakiri, Keita; Sakamoto, Taiji; Noda, Yoichi; Nakahara, Masaaki; Ogino, Nobuchika; Kubota, Toshiaki; Yokoyama, Mitsunobu; Furukawa, Masao; Sonoda, Yoshito; Yamada, Tomomi; Doi, Norihito; Enaida, Hiroshi; Hata, Yoshinobu; Ishibashi, Tatsuro

doi:10.1016/j.ophtha.2006.07.044

Cited by 43 publications

(53 citation statements)

References 19 publications

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“…Triamcinolone acetonide-assisted visualization of the vitreous has been reported as a helpful tool for surgeons performing procedures such as internal limiting membrane peeling or posterior vitreous separation (9)(10)(11)(12)(13)(14)(15)(16) . However, this is the first study to describe the use of triamcinolone-guided 3D vitrectomy in the treatment of diabetic vitreomacular traction.…”

Section: Discussionmentioning

confidence: 99%

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Triamcinolone-assisted 3D-vitrectomy in diabetic vitreomacular traction

Oo¹,

2008

Arq. Bras. Oftalmol.

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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

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Section: Discussionmentioning

confidence: 99%

“…The removal of the vitreous is a particularly challenging procedure, partly because of its transparency (9) . To assist in the visualization of the vitreous during vitrectomy, intraoperative triamcinolone acetonide was used.…”

Section: Vitrectomia 3d Guiada Por Triancinolona Na Tração Vitreomacumentioning

confidence: 99%

Triamcinolone-assisted 3D-vitrectomy in diabetic vitreomacular traction

Oo¹,

2008

Arq. Bras. Oftalmol.

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“…Recent studies showed a decrease in intraoperative complications including retinal detachment and retinal breaks (Yamakiri et al 2007). However, 1-year data showed no difference in visual acuity, need for additional surgeries, and adverse events between TA-assisted PPV and conventional PPV (Yamakiri et al 2008).…”

Section: Triamcinolone During Vitrectomymentioning

confidence: 95%

Use of triamcinolone during vitrectomy surgery to visualize membranes and vitreous

Bakri¹

2008

OPTH

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Abstract:Triamcinolone is a corticosteroid that is used to treat many ophthalmic diseases. Recently, its use has been advocated to aid in visualization of transparent tissue in ophthalmic surgery. It can be used in anterior segment surgery to help manage vitreous loss during complicated cataract surgery. It has been used to visualize the posterior cortical vitreous during pars plana vitrectomy. In addition, it can be useful in the visualization and peeling of the internal limiting membrane. Triamcinolone has been advocated in surgical repair of proliferative vitreoretinopathy both for its visualizing properties and its anti-infl ammatory properties. Overall, triamcinolone use in surgery is safe with low incidence of complications including elevated intraocular pressure, cataract and endophthalmitis.

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“…The largest-scale controlled trial showed that 23 out of 391 eyes (5.9%) had a significant IOP rise in TA-assisted vitrectomy; while 13 out of 383 eyes (3.4%) did so in conventional vitrectomy, a difference which did not reach statistical significance [35]. Most of these rises in intraocular pressure could be managed with topical treatment, but some of them required filtration surgery [8,35]. It should be noted that patients who had a history of glaucoma were not included in these studies.…”

Section: Triamcinolone and Related Materialsmentioning

confidence: 99%

“…In comparison, the incidence of IOP rise was not high after TAassisted vitrectomy, probably due to the fact that TA crystals were almost totally removed at the end of surgery. The largest-scale controlled trial showed that 23 out of 391 eyes (5.9%) had a significant IOP rise in TA-assisted vitrectomy; while 13 out of 383 eyes (3.4%) did so in conventional vitrectomy, a difference which did not reach statistical significance [35]. Most of these rises in intraocular pressure could be managed with topical treatment, but some of them required filtration surgery [8,35].…”

Section: Triamcinolone and Related Materialsmentioning

confidence: 99%