Visualizing vitreous in vitrectomy by triamcinolone

Taiji Sakamoto, Tatsuro Ishibashi

Research output: Contribution to journalReview articlepeer-review

34 Citations (Scopus)

Abstract

Background: Visualizing vitreous and retinal surface during vitrectomy, choromovitrectomy, is a novel approach in vitrectomy. Methods: Triamcinolone acetonide (TA) is now most commonly used as an adjunct to vitrectomy for this purpose. Intraoperative use of TA can visualize posterior hyaloid, preretinal membrane, internal limiting membrane (ILM) during pars plana vitrectomy, and prolapsed vitreous during cataract surgery, which can make the procedure very safe and effective. TA-assisted vitrectomy is favorably applied to surgery for macular hole, proliferative vitreoretinopathy, diabetic retinopathy, uveitis, and others. In addition, this technique can disclose the residual hyaloid cortex pattern after surgical posterior vitreous detachment. Diffuse posterior hyaloids cortex is frequently seen in diabetic retinopathy and high myopia, and an island-like cortex is often left on the macula, which can be a scaffold of future macular pucker. Results: The prospective controlled clinical trial showed that TA-assisted vitrectomy reduced the incidence of intraoperative retinal break and retinal detachment more significantly than conventional vitrectomy, although post-operative visual acuity after 1 year was almost the same with each method. Adverse events related to TA-assisted vitrectomy included transient intraocular pressure elevation (approximately 5.0%); most of these events are manageable with topical treatment. The incidence of acute endophthalmitis was 0.03-0.05%, which was at a level comparable to conventional vitrectomy. Conclusions: In this article, current status and the possible problems of TA-assisted vitrectomy are reviewed.

Original languageEnglish
Pages (from-to)1153-1163
Number of pages11
JournalGraefe's Archive for Clinical and Experimental Ophthalmology
Volume247
Issue number9
DOIs
Publication statusPublished - 2009

All Science Journal Classification (ASJC) codes

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

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