Tognetto Daniele, Zenoni Stefano, Sanguinetti Giorgia, Haritoglou Christos, Ravalico Giuseppe
Eye Clinic, University of Trieste, Trieste, Italy.
Retina. 2005 Jun;25(4):462-7. doi: 10.1097/00006982-200506000-00011.
To evaluate the use of triamcinolone acetonide to stain the internal limiting membrane (ILM) during vitreoretinal surgery.
A prospective clinical interventional case series study was performed, including 16 patients who underwent pars plana vitrectomy. Seven patients had proliferative diabetic retinopathy with macular edema. Seven patients had epiretinal membranes. One patient had a retinal detachment with a cystoid macular edema and proliferative vitreoretinopathy. One patient had a pseudophakic cystoid macular edema. After vitrectomy, 2 mL triamcinolone acetonide suspension was injected into the vitreous cavity. The ILM was peeled, as it was evidenced by the particles of triamcinolone that adhered to its surface. The ultrastructure of tissue harvested during surgery was analyzed using transmission electron microscopy in selected cases to confirm the presence or absence of ILM.
After the injection of triamcinolone, the visualization of the vitreous base and hyaloid was excellent in all patients. The particles of triamcinolone deposited on the retinal surface enabled the ILM to be stained. Once removed, the ILM was clearly distinguishable, floating in the vitreous cavity with particles of triamcinolone adhering to its surface. Ultrastructural analysis of tissue collected during vitrectomy confirmed that the removed tissue represented ILM.
We observed that triamcinolone acetonide can be useful in staining the internal limiting membrane, thus greatly facilitating the retinal ILM peeling. The absence of particles of triamcinolone on the underlying retina enables the area where the ILM has already been removed to be identified.
评估在玻璃体视网膜手术中使用曲安奈德对视网膜内界膜（ILM）进行染色的效果。
进行了一项前瞻性临床干预病例系列研究，纳入16例行玻璃体切除术的患者。7例患有增殖性糖尿病视网膜病变伴黄斑水肿。7例患有视网膜前膜。1例患有视网膜脱离伴黄斑囊样水肿和增殖性玻璃体视网膜病变。1例患有人工晶状体眼黄斑囊样水肿。玻璃体切除术后，向玻璃体腔内注射2 mL曲安奈德混悬液。由于曲安奈德颗粒附着在视网膜内界膜表面，因此可以将其剥离。在部分病例中，使用透射电子显微镜分析手术中采集的组织超微结构，以确认是否存在视网膜内界膜。
注射曲安奈德后，所有患者玻璃体基底部和玻璃体膜的可视化效果均极佳。沉积在视网膜表面的曲安奈德颗粒使视网膜内界膜能够被染色。一旦视网膜内界膜被移除，就可以清晰地辨别出来，漂浮在玻璃体腔内，其表面附着有曲安奈德颗粒。玻璃体切除术中采集的组织的超微结构分析证实，移除的组织为视网膜内界膜。
我们观察到曲安奈德可用于视网膜内界膜染色，从而极大地促进视网膜内界膜的剥离。视网膜表面没有曲安奈德颗粒，这使得已经移除视网膜内界膜的区域得以识别。
