Use of triamcinolone during vitrectomy surgery to visualize membranes and vitreous

Abstract

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.

Triamcinolone Acetonide-Assisted Descemetectomy for Retained Descemet Membrane

“…Furthermore, the use of trypan blue stain has been suggested to highlight the DM [7]. Application of triamcinolone acetonide is by now a well-recognized method for improved intraoperative visualization of vitreous and membranes and was selected in this case to assist with visibility and to provide distinct demarcation of the retained membrane [11].…”

Ophthalmic Trauma-Related Instruments—Critical Tools for Winning the Case

“…Triamcinolone can be used generously during the case to visualize the vitreous. 34 After the anterior vitrectomy, a Weck-Cel should be used to check the paracenteses and traumatic wounds to confirm there are no residual vitreous strands; if there is vitreous present, Weck-Cel vitrectomy can be performed, and further anterior vitrectomy should be pursued until all vitreous is removed. Finally, we do not recommend the insertion of an intraocular lens (IOL) implant during primary lensectomy in open globe repair as the IOL can be a nidus for infection in an already traumatized eye, and there is a high chance of subsequent IOL dislocation due to capsular and zonular trauma.…”

“…Given that the integrity of the posterior lens capsule is unpredictable in open globe injuries, lensectomy should be done with a vitrector; phacoemulsification and irrigation/aspiration should be avoided during lensectomy to prevent inadvertent vitreous traction. Triamcinolone can be used generously during the case to visualize the vitreous 34 . After the anterior vitrectomy, a Weck-Cel should be used to check the paracenteses and traumatic wounds to confirm there are no residual vitreous strands; if there is vitreous present, Weck-Cel vitrectomy can be performed, and further anterior vitrectomy should be pursued until all vitreous is removed.…”

Development of in situ crosslinked hyaluronan as an adjunct to vitrectomy surgery

“…Chromovitrectomy, the procedure to stain living tissues or cells for identifying ocular tissues during the vitrectomy, has been developed and has become popular among vitreoretinal surgeons [ 5 – 9 ]. In particular, visualizing agents such as triamcinolone acetonide (TA) and Brilliant Blue G (BBG) have been popular in many countries [ 10 – 15 ]. These tissue staining agents help visualize injured areas on the retinal surface.…”