Preventing the deposition of triamcinolone in macular hole by use of whole blood in triamcinolone-assisted membrane peeling.
OBJECTIVE
To prevent triamcinolone acetonide (TA) deposition in the macular hole by use of whole blood during TA-assisted internal limiting membrane (ILM) peeling.


METHODS
The prospective, interventional case series study included 18 consecutive idiopathic macular holes (18 patients) that underwent TA-assisted internal limiting membrane (ILM) peeling for macular hole treatment. After core vitrectomy, autologous whole blood was applied to cover the macular hole. Pre-prepared TA solution was gently injected onto the macular area. Residual TA particles were removed after ILM peeling. Closure rate of macular hole, preoperative and postoperative median visual acuity, and retinal changes were evaluated.


RESULTS
Autologous whole blood prevented the deposition of TA particles in the macular hole. The ILM could be recognized after TA-assisted visualization for removal. Average follow-up time was 8.6 months. The hole was closed with one surgery in 17 eyes (94%); visual acuity improved in 15 eyes (83%). Preoperative median best-corrected visual acuity was 20/100 (range = 20/400-20/50). Postoperative median best-corrected visual acuity was 20/40 (range = counting fingers-20/20).


CONCLUSIONS
Whole blood can prevent TA particle deposition in the macular hole. Potential toxicity of TA on retinal pigment epithelium and retina also may be reduced.
Lai
Chi-Chun
CC
Department of Ophthalmology, Chang-Gung Memorial Hospital, Taoyuan, Taiwan. ccl404@cgmh.org.tw
Chuang
Lan-Hsin
LH
Wang
Nan-Kai
NK
Yeung
Ling
L
Chen
Yen-Po
YP
Hwang
Yih-Shiou
YS
Chen
Kuan-Jen
KJ
Wu
Wei-Chi
WC
D000368:Aged; D001485:Basement Membrane / Q000378:metabolism / Q000601:surgery*; D001769:Blood; D019773:Epiretinal Membrane / Q000378:metabolism / Q000601:surgery*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D016684:Prone Position; D011446:Prospective Studies; D012167:Retinal Perforations / Q000175:diagnosis / Q000378:metabolism / Q000601:surgery*; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D041623:Tomography, Optical Coherence; D014222:Triamcinolone Acetonide / Q000008:administration & dosage* / Q000378:metabolism; D014792:Visual Acuity; D014821:Vitrectomy
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide; D013459:Sulfur Hexafluoride