Abstract
Background Newly developed intraretinal cystoid changes after vitrectomy with membrane peeling
for removal of epiretinal membranes have the potential to lead to worse postsurgical
results compared to patients without. The aim of the present study was to evaluate
the feasibility of additional periocular application of triamcinolone acetonide as
a routine adjunct at the end of vitrectomy with membrane peeling, and to compare the
presence of postsurgical intraretinal cystoid changes in the first 3 months after
surgery among patients with idiopathic epiretinal membranes to a historical group
of patients that did not receive triamcinolone acetonide.
Patients and Methods The medical records of 41 eyes of 41 patients that underwent 23 G or 25 G pars plana
vitrectomy with membrane peeling for removal of epiretinal membranes and additional
periocular triamcinolone acetonide application at the end of surgery were retrospectively
reviewed. Optical coherence tomography findings during routine follow-ups at 3 – 5
days, 1 month, and 3 months and visual acuity at 3 months after surgery were evaluated
and compared to preoperative findings. Furthermore, postsurgical intraocular pressure
was assessed.
Results Periocular triamcinolone acetonide at the end of surgery was well tolerated among
all patients. In total, 10% of patients had an increased intraocular pressure at least
at one follow-up. Best-corrected visual acuity improved in 91% of patients with idiopathic
epiretinal membranes with a mean improvement of + 3 ± 2 lines (Snellen) and was comparable
to a historic group of patients (p = 0.307). Early transient macular edema could not
be detected in any of the patients, while there were cases with this pathology in
the historic group of patients, but neither occurrence of newly developed intraretinal
cystoid changes nor macular thickness at 3 months after surgery were significantly
different between patients with and without triamcinolone acetonide (p = 0.385 and
p = 0.879).
Conclusions Periocularly applied triamcinolone acetonide at the end of vitrectomy with membrane
peeling was well tolerated and showed prevention of early transient macular edema
but did not prevent the development of new postoperative intraretinal cystoid changes.
Key words
periocular triamcinolone acetonide - new postoperative intraretinal cystoid changes
- early transient macular edema - vitrectomy with membrane peeling - epiretinal membranes
