Efficacy and Safety of Postvitrectomy Intravitreal Triamcinolone Therapy for Diabetic Macular Edema

Costa, José Ferreira; Sousa, Keissy; Marques, João Pedro; Marques, Marco Frederico; Cachulo, Maria da Luz; Silva, Rufino; Gomes, Nuno; Figueira, João

doi:10.5301/ejo.5000768

Cited by 12 publications

(10 citation statements)

References 33 publications

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“…At present, intravitreal injection of conbercept or triamcinolone acetonide ophthalmic is mostly used to reconstruct the blood-retinal barrier in patients with diabetic macular edema in clinical practice [ 13 ]. Triamcinolone acetonide is an adrenocortical hormone drug, which has the effects of local, antiallergic, inhibiting neovascularization and cell proliferation, reducing vascular permeability, and stabilizing the blood-retinal barrier, and can improve macular edema [ 14 , 15 ]. Corbercept, as an intravitreal vascular endothelial growth factor (VEGF) inhibitor, has good clinical efficacy in the treatment of diseases such as diabetic macular edema [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Intravitreal Injection of Triamcinolone Acetonide and Conbercept for Intraocular Lens after Cataract Surgery

Tang¹,

Wang

Luo³

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To investigate the effect of intravitreal injection of triamcinolone acetonide and conbercept on the efficacy and safety of diabetic macular edema (DME) after cataract intraocular lens (IOL) surgery. Methods. A total of 350 patients with cataract complicated with diabetic macular edema in our hospital from January 2017 to July 2021 were randomly divided into conbercept group and triamcinolone acetonide group. Patients in the conbercept group were given intravitreal injection of conbercept during IOL surgery, and patients in the triamcinolone acetonide group were given injection of triamcinolone acetonide during surgery. Results. Three months after treatment, the best-corrected visual acuity of the two groups was significantly higher than before, the corrected visual acuity of the conbercept group was more significant than the triamcinolone acetonide group, and the intraocular pressure of the triamcinolone acetonide group was higher than the conbercept group. The foveal thickness and macular volume were significantly reduced in both groups, and was reduced more in the conbercept group than in the triamcinolone acetonide group. The contents of VEGF, SDF-1, and IL-6 in both groups were significantly decreased, and the decrease was more significant in the conbercept group than in the triamcinolone acetonide group. The patients with elevated intraocular pressure, headache and vomiting, orbital swelling pain, eye swelling pain, and eye pain in the triamcinolone acetonide group were significantly higher than those in the conbercept group ( P < 0.05 ). Conclusions. Conbercept and triamcinolone acetonide has a good therapeutic effect on DME in pseudophakic eyes after cataract IOL surgery, which can reduce the degree of macular edema and improve the visual function. However, the therapeutic effect of injection therapy with conbercept is safe, the prognosis is better, and the complication rate is low.

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Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Intravitreal Injection of Triamcinolone Acetonide and Conbercept for Intraocular Lens after Cataract Surgery

Tang¹,

Wang

Luo³

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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“…[ 11 ] Routinely given intravitreal injections after PPV for any indication are also considered to be safe in the perspective of IRBs, even in the case of triamcinolone, which is crystal-based. [ 12 ] The difference between these office procedures and VRS related injections in our series is two-pronged. First, in cases 1 and 4, the eye was air-filled.…”

Section: Discussionmentioning

confidence: 94%

Jet stream related iatrogenic retinal breaks during vitreo-retinal surgery

Takkar

Belenje

Agarwal

et al. 2022

Indian Journal of Ophthalmology

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Purpose: To evaluate the causes of jet stream injury (JSI)-related iatrogenic retinal breaks (IRBs) during vitreoretinal surgery (VRS). Methods: The precise surgical environment, which includes the indication and type of surgical procedure, retina status, details of instrumentation and fluidic parameters, and characteristics of the jet responsible for the IRB, was noted from case records. The nature of IRB and its healing and impact on anatomical and visual outcomes were analyzed. Results: Five eyes of five patients with complete documentation of both the JSI and the IRB were included. Two cases were operated for macular hole, and one each for vitreous hemorrhage, retinal detachment, and endophthalmitis. One case had infusion-fluid-related JSI, while four developed it because of injection of surgical adjuncts (drugs, PFCL, and dye). JSI developed in two cases when the vitreous cavity was filled with fluid, while it was air-filled in three cases. In four cases, the fluid migrated into subretinal space, necessitating further maneuvers following which the breaks healed, but were directly responsible for vision loss in two cases. Conclusion: JSI related IRBs are rare but may be directly responsible for vision loss if they impact the macula. The balance between jet stream velocity, its distance from the retinal surface, the intervening media (vitreous cavity), and retinal health play an important role. It can occur because of both infusion as well as injection jets. Precautions must be taken in cases vulnerable to complications with suggested modifications in the surgical technique.

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“…These results indicate the increase in clearance of anti-VEGFs in vitrectomized eyes. Unlike anti-VEGFs, intravitreal DEX has slow drug release due to its free-floating biodegradable copolymer structure containing micronized dexamethasone, and intravitreal TA has more prolonged effects due to its crystal structure that provides limited solubility [8, 9]. We administered intravitreal anti-VEGF to 21% of patients in both groups.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Intravitreal Dexamethasone Implant and Posterior Subtenon Triamcinolone Injection in the Treatment of Diabetic Macular Edema in Vitrectomized Eyes

et al. 2022

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PURPOSE: To compare posterior subtenon triamcinolone (PSTA) application and intravitreal dexamethasone phosphate (DEX) implant in the treatment of diabetic macular edema (DME) in vitrectomized eyes. METHODS: This retrospective study included 64 (48.12 %) patients who received PSTA and 69 (51.88 %) patients who received DEX implants in DME treatment after vitrectomy. Best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) were analyzed before injection, at 1, 3 and 6 months after injection. The post-injection values were statistically compared with the pre-injection value. RESULTS: All post-injection CMT values in both groups were lower than the pre-injection value. (p< 0.05 for all) There were statistically significant increases in all post-injection BCVAs of the DEX group and post-injection 1-month BCVA of the PSTA group. (p< 0.05 for all) However, there was no significant difference in BCVA values of the PSTA group at 3 and 6 months after injection. (p> 0.05 for both) There was no statistically significant difference in all post-injection IOP values of the PSTA group. (p> 0.05 for all) However, significant increases in IOP were observed in the DEX group at 1 and 3 months after injection. (p<0.05 and p=0.02 respectively) The number of additional injections between the 3rd and 6th months after the initial injection was statistically higher in the PSTA group. (p= 0.006) CONCLUSION: Both intravitreal DEX and PSTA administration are effective in the treatment of DME after vitrectomy. However, visual improvement persisted longer, and the need for additional injections was less in patients who received DEX.

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Efficacy and Safety of Postvitrectomy Intravitreal Triamcinolone Therapy for Diabetic Macular Edema

Cited by 12 publications

References 33 publications

Efficacy and Safety of Intravitreal Injection of Triamcinolone Acetonide and Conbercept for Intraocular Lens after Cataract Surgery

Efficacy and Safety of Intravitreal Injection of Triamcinolone Acetonide and Conbercept for Intraocular Lens after Cataract Surgery

Jet stream related iatrogenic retinal breaks during vitreo-retinal surgery

Comparison of Intravitreal Dexamethasone Implant and Posterior Subtenon Triamcinolone Injection in the Treatment of Diabetic Macular Edema in Vitrectomized Eyes

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