title: Triamcinolone-assisted pars plana vitrectomy improves the surgical procedures and decreases the postoperative blood-ocular barrier breakdown.
abstract: OBJECTIVE
  To determine the effect of a triamcinolone-assisted pars plana vitrectomy (PPV) on the visibility of hyaloid during surgery and the postoperative clinical outcome.
  
  
  METHODS
  Thirty-one patients with proliferative retinal disease [8 with diabetic macular edema (DME), 10 with proliferative diabetic retinopathy (PDR), 13 with proliferative vitreoretinopathy (PVR)] underwent PPV, where the vitreous body was visualized by the intravitreal injection of triamcinolone solution during the operation. The visual acuity, intraocular pressure (IOP), tamponade, corneal pathology, after-cataract, vitreous hemorrhage, and necessity of reoperation, were thereafter examined for at least 3 months after surgery. The anterior chamber laser flare cell meter was used on postoperative day 8 in DME eyes with triamcinolone-assisted PPV and with routine PPV to evaluate the breakdown of the blood-ocular barrier.
  
  
  RESULTS
  The vitreous body was clearly seen by means of triamcinolone during surgery, which greatly helped us to perform a posterior hyaloid resection safely and thoroughly. Six of 8 DME eyes, 8 of 10 PDR eyes, and 5 of 13 PVR eyes showed an improvement in their vision postoperatively. No eye except one experienced IOP elevation above 21 mmHg for 7 days. Six eyes had vitreous hemorrhage. The DME eyes which received triamcinolone-assisted PPV showed significantly less breakdown of the blood-ocular barrier than those with routine PPV (Mann-Whitney U-test, P<0.01).
  
  
  CONCLUSIONS
  Triamcinolone improved the visibility of the hyaloid and the safety of the surgical procedures during PPV and also inhibited the postoperative breakdown of the blood-ocular barrier. Although the long-term effects are still unknown, this method appears potentially useful as an improved treatment for proliferative retinal diseases.
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-82, Japan. tsakamot@eye.med.kyushu-u.ac.jp
authors.forename: Taiji
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Miho
authors.initials: M
authors.lastname: Miyazaki
authors.forename: Toshio
authors.initials: T
authors.lastname: Hisatomi
authors.forename: Takao
authors.initials: T
authors.lastname: Nakamura
authors.forename: Akifumi
authors.initials: A
authors.lastname: Ueno
authors.forename: Keiko
authors.initials: K
authors.lastname: Itaya
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Ishibashi
mesh_terms: D018916:Blood-Aqueous Barrier / Q000187:drug effects*; D001813:Blood-Retinal Barrier / Q000187:drug effects*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D012164:Retinal Diseases / Q000601:surgery*; D014222:Triamcinolone Acetonide / Q000627:therapeutic use*; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*
chemical_list: D007166:Immunosuppressive Agents; D014222:Triamcinolone Acetonide