| ObjectiveTo observe the change of intraocular pressure and other parts of eyes after injection triamcinolone acetonide in line with vitrectomy operation, and investigate the efficacy and postoperative complications of triamcinolone acetonide, and discuss the safety of intravitreal low-dose triamcinolone acetonide.Patients and MethodsClinical screening 116 different causes (116 eyes), in need of vitrectomy, were injected in different doses of triamcinolone acetonide in prospective studies, from September 2008 to Sepember 2009, including male 65 cases, with female 51 cases, The age was arranged from 17 to 71, with an average age of 35.116 cases were performed close type, Conventional dyeing with triamcinolone acetonide in helping vitrectomy in 5 eyes, and 2mg triamcinolone acetonide were injected into the vitreous body of 21 eyes, and 25 eyes were injected with 4mg triamcinolone acetonide, and 6 silicone oil filled eyes were injected with triamcinolone acetonide for conventional dyeing for vitrectomy, and 23 silicone oil filled eyes, including 9 eyes filled with heavy silicone oil,were injected with lmg triamcinolone acetonide, and 36 silicone oil filled eyes were injected with 2mg triamcinolone acetonide. In the aseptic conditions vitrectomy operation process washed triamcinolone acetonide was injected into vitreous body. According to the condition, vitrectomy combined with resection of the lens, retinal detachment or resection, former film retinal laser photocoagulation, silicone oil. The lml syringe injected triamcinolone acetonide directly into the vitreous body. The intraocular pressure was measured many times to eliminate patients with high intraocular pressure before vitrectomy. A cornerstone UBM mirror, check out a cornerstone adhesion, slit lamp, ophthalmoscope, B ultrasonic inspection teats, color and fundus retinal fundus fluorescein angiography, optical coherence tomography preoperative record the examination of eyes. Eliminate high intraocular pressure and family history of glaucoma, and eliminate body and vitreous which were glucocorticoid contra-indications. Postoperative observation patient 1 day,3days, 1week,1 month,2 months,3 months of intraocular pressure, inflammation, lens, retina and visual acuity etc, in order to record the eyes injected with triamcinolone acetonide, discover complications and curative effect, and choose the appropriate treatment.ResultsIn the 116 cases, during the follow-up observations, intraocular pressure was elevated over 5mmHg in 37 cases, accounting for 39 percent, and intraocular pressure was elevated over 10mmHg in 16 cases. The intraocular pressure of all the 116 cases increased above 21mmHg, with 6 cases between 22mmHg and 30mmHg,5 cases between 30mmHg and 40mmHg,5 cases intraocular pressure elevated over 40mmHg, 1 case reached 59 mmHg, the highest elevated intraocular pressure. Simply used triamcinolone acetonide vitreous dyeing auxiliary vitrectomy did not elevate intraocular pressure. In 21 eyes, injected of 2mg triamcinolone acetonide,2 eyes elevated intraocular pressure over 5mmHg,1 eye elevated intraocular pressure over 10mmHg. In 25eyes, injected of 4mg triamcinolone acetonide,6 eyes elevated over 5mmHg,4 eyes elevated intraocular pressure over 10mmHg. In 23 silicone oil filled eyes, injected of 2mg triamcinolone acetonide,4 eyes elevated intraocular pressure over 5mmHg,2 eyes elevated intraocular pressure over 10mmHgs. In 36 silicone oil filled eyes, injected of 4 mg triamcinolone acetonide,20 eyes elevated over 5mmHg, 9 eyes elevated intraocular pressure over 10mmHg. The research group in 37cases with intraocular pressure increased,17 cases, combined with high myopia, accounting for 46%, elevated intraocular pressure. The clearance time of triamcinolone acetonide was 3 days to 3 months, and was related to the does of intravitreal triamcinolone acetonide and filled with silicone oil. Conclusions1 The complications of increased intraocular pressure and concurrent sexual cataract in intravitreal 2 mg low-dose triamcinolone acetonide eyes were less than intravitreal 4 mg triamcinolone acetonide eyes, and it was safer after injection triamcinolone acetonide in line with vitrectomy operation.2 In complicated vitreoretinal surgery, intravitreal injection 2 mg triamcinolone acetonide was effective in decreasing inflammatory reaction and restraining proliferative vitreoretinopathy. Nearly all the eyes with elevated intraocular pressure after vitrectomy surgery were controlled by drug.3 The rate of patients combined with high myopia, was higher than that of other patients with elevated intraocular pressure,.Filled with silicone oil can extend the duration of the elevated intraocular pressure. So we should decrease the dose of triamcinolone acetonide appropriately, which would not reduce curative effect... |
