Ozkiriş Abdullah, Erkiliç Kuddusi
Department of Ophthalmology, Erciyes University Medical Faculty, Kayseri, Turkey.
Can J Ophthalmol. 2005 Feb;40(1):63-8. doi: 10.1016/S0008-4182(05)80119-X.
Intravitreal injection of triamcinolone acetonide appears to be a promising treatment for a variety of proliferative, edematous, neovascular and inflammatory ocular disorders. Reported complications include intraocular pressure (IOP) elevation, cataract formation, retinal detachment, vitreous hemorrhage and endophthalmitis. The purpose of this investigation was to report the complications of intravitreal triamcinolone injection that may be attributable to the injection procedure or to the corticosteroid suspension.
A total of 212 eyes of 180 patients who underwent intravitreal triamcinolone acetonide injection for various indications were enrolled. All patients received 8 mg/0.2 mL of triamcinolone. A total of 270 injections were performed by the same surgeon under topical anesthesia. The patients were followed for a mean of 9.2 months. Complications related to the injection procedure and to the corticosteroid were recorded.
The most common complication encountered during follow-up was transient elevation of the IOP above 21 mm Hg (44 eyes [20.8%]). The average IOP rose by 28.5%, 38.2%, 16.7% and 4.2% from baseline at 1, 3, 6 and 9 months respectively. The mean IOP values at 1, 3 and 6 months were statistically significantly higher than the mean preinjection value (p < 0.001). Fourteen eyes (6.6%) had cataract progression and underwent cataract surgery with intraocular lens implantation. Endophthalmitis developed in one eye (0.5%); the patient underwent vitrectomy with silicone oil injection. Pseudoendophthalmitis occurred in one eye (0.5%), and pseudohypopyon was observed in two eyes (0.9%).
Intravitreal triamcinolone injection was effective in a variety of ocular disorders. Patients should be monitored closely given the potential for complications of the injection procedure or the corticosteroid suspension.
玻璃体内注射曲安奈德似乎是治疗多种增殖性、水肿性、新生血管性和炎性眼部疾病的一种有前景的治疗方法。报道的并发症包括眼压（IOP）升高、白内障形成、视网膜脱离、玻璃体积血和眼内炎。本研究的目的是报告可能归因于注射操作或皮质类固醇混悬液的玻璃体内注射曲安奈德的并发症。
纳入180例因各种适应证接受玻璃体内注射曲安奈德的患者的212只眼。所有患者均接受8mg/0.2mL曲安奈德。同一位外科医生在表面麻醉下共进行了270次注射。患者平均随访9.2个月。记录与注射操作和皮质类固醇相关的并发症。
随访期间最常见的并发症是眼压短暂升高超过21mmHg（44只眼[20.8%]）。眼压分别在1、3、6和9个月时从基线水平平均升高28.5%、38.2%、16.7%和4.2%。1、3和6个月时的平均眼压值在统计学上显著高于注射前平均眼压值（p<0.001）。14只眼（6.6%）出现白内障进展并接受了白内障手术及人工晶状体植入。1只眼（0.5%）发生眼内炎；患者接受了玻璃体切除术并注入硅油。1只眼（0.5%）发生假眼内炎，2只眼（0.9%）观察到假性前房积脓。
玻璃体内注射曲安奈德对多种眼部疾病有效。鉴于注射操作或皮质类固醇混悬液可能引发并发症，应对患者进行密切监测。
