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Impressum
Intravitreal Injection of Crystalline Cortisone as Adjunctive Treatment of Proliferative Vitreoretinopathy
Soefker A., Jonas J. B.
Department of Ophthalmology and Eye Hospital, Faculty of Clinical Medicine Mannheim, Ruprecht-Karls-University Heidelberg
Objective: To report on clinical outcome and complications of
intravitreal injection of crystalline cortisone in patients undergoing
pars plana vitrectomy for treatment of proliferative vitreoretinopathy.
Methods: The study included all 16 patients who underwent pars
plana vitrectomy for treatment of proliferative vitreoretinopathy, who
received an intravitreal injection of 10 to 20 mg crystalline triamcinolon
acetonide at the end of surgery, and who were operated on by the same
surgeon. Most of the vehicle of the solution containing the cortisone
crystals was removed before performing the injection. Mean follow-up time
was 1.64 ± 2.15 months (mean ± S.D.; median, 1.23 months;
range, 0.20 to 9.20 months). The study group was compared with a control
group which consisted of 144 patients undergoing pars plana vitrectomy
for proliferative vitreoretinopathy performed by the same surgeon.
Results: In the study group compared with the control group, intraocular
inflammation, as estimated clinically upon slit lamp biomicroscopy, was
lower, appearance of the fundus upon ophthalmoscopy in the first postoperative
week was clearer, and postoperative pain in the first two postoperative
days was reduced. Intraocular pressure measured at the end of the first
postoperative week did not vary significantly between the groups. A pseudo-hypopyon
consisting of cortisone crystals in the inferior anterior chamber angle
was detected in one patient. Postoperative infectious endophthalmitis
was not encountered.
Conclusion: This pilot study suggests that intravitreal injection
of crystalline cortisone with most of the vehicle removed is not toxic
to intraocular structures, reduces postoperative intraocular inflammation,
and may be a potentially useful additional tool in the treatment of proliferative
vitreoretinopathy.