Faghihi Hooshang, Taheri Arash, Farahvash Mohammad Sadegh, Esfahani Mohammad Riazi, Rajabi Mohammad Taher
Department of Ophthalmology, School of Medicine, Medical Sciences, Tehran University, Tehran, Iran.
Retina. 2008 Oct;28(9):1241-6. doi: 10.1097/IAE.0b013e31817d5be3.
To evaluate the clinical outcome and complications of intravitreal injections of triamcinolone acetonide in patients undergoing pars plana vitrectomy for treatment of diabetic nonclearing vitreous hemorrhage.
This prospective, randomized clinical trial study included 72 consecutive patients (72 eyes) who underwent pars plana vitrectomy for treatment of diabetic nonclearing vitreous hemorrhage. 38 patients received an intravitreal injection of 4 mg (0.1 cc) of triamcinolone acetonide at the end of surgery. Main outcome measures were rate of recurrent early vitreous hemorrhage, reoperation, intraocular pressure, visual acuity, and incidence of cataract formation. Mean follow-up time was 6 months.
Rate of early rebleeding and reoperation were lower in patients taking intravitreal triamcinolone (P = 0.003 and 0.03, respectively). Visual acuity 6 months after operation was better in study group (P < 0.001). Mean intraocular pressure was higher 1 day and 1 week after procedure in study group compared with control group (P < 0.001 and 0.002, respectively); however, in other times its differences were not significant. No significant difference in rate of nuclear sclerosis and cortical cataract formation and other complication was noted between the two groups. However, there was a significantly increased rate of posterior subcapsular progression in a dose dependent manner in the study group versus control (P = 0.011).
The present clinical study suggests that intravitreal injection of triamcinolone acetonide is effective in the prevention of rebleeding in eyes undergoing pars plana vitrectomy for treatment of diabetic vitreous hemorrhage.
评估玻璃体内注射曲安奈德对接受玻璃体切割术治疗糖尿病性不吸收性玻璃体积血患者的临床疗效及并发症。
这项前瞻性随机临床试验研究纳入了72例连续接受玻璃体切割术治疗糖尿病性不吸收性玻璃体积血的患者（72只眼）。38例患者在手术结束时接受了玻璃体内注射4毫克（0.1毫升）曲安奈德。主要观察指标为早期玻璃体再出血率、再次手术率、眼压、视力及白内障形成发生率。平均随访时间为6个月。
接受玻璃体内曲安奈德注射的患者早期再出血率和再次手术率较低（分别为P = 0.003和0.03）。研究组术后6个月视力更好（P < 0.001）。与对照组相比，研究组术后1天和1周时平均眼压较高（分别为P < 0.001和0.002）；然而，在其他时间其差异无统计学意义。两组间核硬化和皮质性白内障形成率及其他并发症无显著差异。然而，与对照组相比，研究组后囊下进展率呈剂量依赖性显著增加（P = 0.011）。
本临床研究表明，玻璃体内注射曲安奈德对接受玻璃体切割术治疗糖尿病性玻璃体积血的眼睛预防再出血有效。
