Ahmadieh Hamid, Feghhi Mostafa, Tabatabaei Homa, Shoeibi Nasser, Ramezani Alireza, Mohebbi Mohammad Reza
Ophthalmic Research Center, Labbafinejad Medical Center, Shahid Beheshti University, M.C., Tehran, Iran.
Ophthalmology. 2008 Nov;115(11):1938-43. doi: 10.1016/j.ophtha.2008.05.016. Epub 2008 Jun 26.
To evaluate the effect of adjunctive intraocular triamcinolone acetonide (TA) in silicone-filled eyes on outcomes of vitreoretinal surgery for proliferative vitreoretinopathy (PVR).
Prospective, randomized, controlled clinical trial.
Seventy-five eyes with rhegmatogenous retinal detachment and PVR grade C (posterior, anterior, or both) undergoing vitrectomy combined with silicone oil tamponade were included. Of these, 38 eyes were assigned randomly to the adjunctive treatment, whereas 37 eyes served as controls.
All eyes underwent pars plana vitrectomy, membrane peeling, and silicone oil exchange, with or without relaxing retinotomy or retinectomy. In the treatment group, 4 mg TA was injected into the silicone-filled vitreous cavity at the end of the procedure. Silicone oil was removed 3 months after surgery in eyes with attached retinas.
The primary outcome measure was retinal reattachment rate at 6 months. Secondary outcome measures included visual acuity, rate of recurrent PVR, reoperation rate, and rise of intraocular pressure.
Retinal reattachment without any reoperation was achieved in 32 eyes (84.2%) and 29 eyes (78.4%) in the adjunctive treatment and control groups, respectively, at 6 months (P = 0.5). No statistically significant difference was observed between the 2 groups in terms of any of the secondary outcome measures (P>0.05).
The outcomes of vitreoretinal surgery for established PVR are not improved significantly by adjunctive TA injection in silicone-filled eyes.
评估玻璃体内注射曲安奈德（TA）对硅油填充眼增殖性玻璃体视网膜病变（PVR）玻璃体视网膜手术预后的影响。
前瞻性、随机、对照临床试验。
纳入75例孔源性视网膜脱离且PVR为C级（后部、前部或两者皆有）并接受玻璃体切除术联合硅油填充的患者。其中，38例患者的眼睛被随机分配接受辅助治疗，37例患者的眼睛作为对照。
所有患者均接受玻璃体切割术、膜剥除术和硅油置换术，可进行或不进行视网膜切开或视网膜切除术。治疗组在手术结束时向硅油填充的玻璃体腔注射4mg TA。视网膜复位的患者在术后3个月取出硅油。
主要观察指标为6个月时的视网膜复位率。次要观察指标包括视力、PVR复发率、再次手术率和眼压升高情况。
辅助治疗组和对照组分别有32例（84.2%）和29例（78.4%）患者在6个月时实现视网膜复位且无需再次手术（P = 0.5）。两组在任何次要观察指标方面均未观察到统计学显著差异（P>0.05）。
对于已确诊的PVR，在硅油填充眼中辅助注射TA并不能显著改善玻璃体视网膜手术的预后。
