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Abstract #16873 Published in IGR 9-1
Intraocular pressure after intravitreal injection of triamcinolone acetonide following vitrectomy for macular edema
Yamashita T; Uemura A; Kita H; Sakamoto TJournal of Glaucoma 2007; 16: 220-224
PURPOSE: To evaluate long-term intraocular pressure (IOP) response after intravitreal injections of different doses of triamcinolone acetonide (TA) upon completion of pars plana vitrectomy (PPV) for macular edema secondary to diabetic retinopathy or retinal vein occlusion. PATIENTS AND METHODS: Retrospective, consecutive, comparative, interventional case series. Twenty-seven eyes of 25 consecutive patients with macular edema associated with diabetic retinopathy (n = 18) or retinal vein occlusion (n = 9), who underwent PPV for the treatment of macular edema between January 2003 and December 2003, were included. Upon completion of vitrectomy, different doses of TA were injected into the vitreous cavity: 14 eyes with 5 mg of TA (group 1) and 13 eyes with 10 mg of TA (group 2). The main outcome measure was IOP. RESULTS: All patients were followed up for at least 12 months. Preoperative IOP was 12.6 ± 2.6 mmHg (mean ± standard deviation) in group 1 and 13.2 ± 2.1 mmHg in group 2. Postoperatively, IOP increased to a mean maximum of 20.6 ± 5.5 mmHg in group 1 and 31.5 ± 3.5 mmHg in group 2 (P < 0.01 for both groups). The difference between groups was also significant (P < 0.05). Five of 14 eyes (36%) in group 1 and 10 of 13 eyes (77%) in group 2 had an elevation of IOP exceeding 21 mmHg (P = 0.03). The median interval from surgery to reach maximal IOP was 7 days in both groups. The significant IOP elevation lasted for 3 months in group 1 and 6 months in group 2. CONCLUSIONS: After injecting of TA into the vitreous cavity upon completion of PPV for macular edema, a dose-dependent IOP elevation was observed, starting from early postoperative days and returning to normal values after several months. These results show that intravitreal TA injection in the vitrectomized eyes might have different IOP changes from in the nonvitrectomized eyes.
Dr. T. Yamashita, Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima, Japan. take1@m.kufm.kagoshima-u.ac.jp
Classification:
9.4.1 Steroid-induced glaucoma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
13.2.1 IOP (Part of: 13 Therapeutic prognosis and outcome > 13.2 Outcome)