title: [Persistent unsealed sclerotomy after intravitreal injection of triamcinolone acetonide with a 30-gauge needle].
abstract: We report the case of a persistent unsealed sclerotomy following intravitreous injection of triamcinolone through the pars plana using a 30-gauge needle. The injection was made for the treatment of diabetic macular edema. The eye had been treated 9 months before by pars plana vitrectomy and pan retinal photocoagulation for vitreous hemorrhage complicating diabetic proliferative retinopathy. Five days after injection, the patient presented with severe hypotony and chemosis. A conjunctival Seidel was noted at the site of injection. Surgical exploration revealed a punctiform scleral wound without vitreous incarceration, which was closed with a 10-0 nylon suture. No other complication occurred. Our observation highlights that in spite of its simplicity, intravitreous injection of triamcinolone is an invasive procedure that requires rigorous follow-up. In vitrectomized eyes, the higher risk of unsealed scleral wound after intravitreous injection should encourage this injection to be made in a site where no sclerotomy usually occurs. The 6'o-clock meridian could be a good location.
authors.affiliation: Service d'Ophtalmologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon. jj.gambrelle@club-internet.fr
authors.forename: J
authors.initials: J
authors.lastname: Gambrelle
authors.forename: L
authors.initials: L
authors.lastname: Kodjikian
authors.forename: N
authors.initials: N
authors.lastname: Abi-Ayad
authors.forename: B
authors.initials: B
authors.lastname: Wolff
authors.forename: J D
authors.initials: JD
authors.lastname: Grange
mesh_terms: D000328:Adult; D004867:Equipment Design; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007267:Injections / Q000009:adverse effects; D008297:Male; D009339:Needles / Q000009:adverse effects; D012590:Sclera / Q000293:injuries*; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*; D014822:Vitreous Body
chemical_list: D005938:Glucocorticoids; D014222:Triamcinolone Acetonide