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NR 4-6/2008
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Zmniejszenie
pooperacyjnego odczynu zapalnego wskutek zastosowania octanu
triamcynolonu podczas witrektomii pars plana
Decrease of the
postoperative inflammatory reaction during pars plana vitrectomy
(PPV) after administration of triamcinolone acetonide
Anna Mańkowska, Robert Rejdak, Agnieszka
Oleszczuk, Magdalena Kiczyńska, Anna Łękawa, Tomasz Chorągiewicz,
Zbigniew Zagórski
Katedra i Klinika Okulistyki Akademii Medycznej w Lublinie
Kierownik: dr hab. n. med. Tomasz Żarnowski |
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| Summary: |
Purpose: To
prospectively evaluate the effect on postoperative
inflammatory reaction and recovery after application of
triamcinolone acetonide (TA) during pars plana
vitrectomy (PPV), to visualize the vitreous.
Material and methods: Pars plana vitrectomy (PPV)
was performed in 45 patients (21 males, 24 females) (29
with retinal detachment, 6 with macular hole, 1 with
cystoid macular edema, 3 with diabetic retinopathy, 3
with vitreous haemorrhage, 1 with preretinal membrane, 1
with PVR and 1 with lens luxation). After surgical
separation of the posterior vitreous and removal of any
visible epiretinal membrane, TA was injected over the
posterior pole. For the control group we used 15
patients (10 with retinal detachment, 2 with macular
hole, 1 with preretinal membrane, 1 with lens luxation
and 1 with vitreous haemorrhage) (10 males, 5 females)
treated with PPV but without TA administration. To
evaluate the degree of postoperative inflammation and to
monitor the dynamics of the blood-aqueous barrier
disruption, the laser flare cell meter (Kowa FM-500) was
used.
Results: Tyndalometric mean values in the control
group of eyes recorded 1 day after PPV were 32.41 ± 6.1
ph/ msec while values in TA-treated group were
significantly lower (20.26 ± 2.4, p<0.02). 10 days after
surgery in TA group results were still significantly
lower as compared to the control group (16.4 ± 2.6 vs
32.5 ± 9.6, p<0.005). As observed 6 weeks after PPV,
tyndalometric recordings in TA-treated group remained
lower as those observed in the control group (16.1 ± 3.1
vs 32.0 ± 8.1, p<0.01).
Conclusions: The eyes which received TA-assisted
PPV showed significantly less breakdown of the blood–ocular
barrier than those with routine PPV. Intraoperative
administration TA facilitates postoperative recovery
after surgery lowering the inflammatory reaction. |
| Słowa kluczowe: |
octan triamcynolonu, ciało
szkliste, witrektomia pars plana. |
| Key words: |
triamcinolone acetonide,
vitreous, pars plana vitrectomy. |
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