Intravitreal triamcinolone acetonide injection at the end of vitrectomy for diabetic vitreous hemorrhage: a randomized, clinical trial.
OBJECTIVE
To evaluate the clinical outcome and complications of intravitreal injections of triamcinolone acetonide in patients undergoing pars plana vitrectomy for treatment of diabetic nonclearing vitreous hemorrhage.


METHODS
This prospective, randomized clinical trial study included 72 consecutive patients (72 eyes) who underwent pars plana vitrectomy for treatment of diabetic nonclearing vitreous hemorrhage. 38 patients received an intravitreal injection of 4 mg (0.1 cc) of triamcinolone acetonide at the end of surgery. Main outcome measures were rate of recurrent early vitreous hemorrhage, reoperation, intraocular pressure, visual acuity, and incidence of cataract formation. Mean follow-up time was 6 months.


RESULTS
Rate of early rebleeding and reoperation were lower in patients taking intravitreal triamcinolone (P = 0.003 and 0.03, respectively). Visual acuity 6 months after operation was better in study group (P < 0.001). Mean intraocular pressure was higher 1 day and 1 week after procedure in study group compared with control group (P < 0.001 and 0.002, respectively); however, in other times its differences were not significant. No significant difference in rate of nuclear sclerosis and cortical cataract formation and other complication was noted between the two groups. However, there was a significantly increased rate of posterior subcapsular progression in a dose dependent manner in the study group versus control (P = 0.011).


CONCLUSIONS
The present clinical study suggests that intravitreal injection of triamcinolone acetonide is effective in the prevention of rebleeding in eyes undergoing pars plana vitrectomy for treatment of diabetic vitreous hemorrhage.
Faghihi
Hooshang
H
Department of Ophthalmology, School of Medicine, Medical Sciences, Tehran University, Tehran, Iran.
Taheri
Arash
A
Farahvash
Mohammad Sadegh
MS
Esfahani
Mohammad Riazi
MR
Rajabi
Mohammad Taher
MT
D000328:Adult; D000368:Aged; D002386:Cataract / Q000503:physiopathology; D048909:Diabetes Complications; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007267:Injections; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D012086:Reoperation; D055502:Secondary Prevention; D014222:Triamcinolone Acetonide / Q000008:administration & dosage* / Q000009:adverse effects; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods; D014822:Vitreous Body; D014823:Vitreous Hemorrhage / Q000209:etiology* / Q000601:surgery*; D055815:Young Adult
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide