Improvement of Visual Acuity One-year After Vitreous Surgery in Eyes with Residual Triamcinolone Acetonide at the Macular Hole

• Published in: American journal of ophthalmology 2008-02, Vol.145 (2), p.267-272.e1
• Main Authors: Hikichi, Taiichi, Furukawa, Yuuko, Ohtsuka, Hideo, Higuchi, Makoto, Matsushita, Takuro, Ariga, Hiroko, Kosaka, Shyoko, Matsushita, Reiko
• Format: Article
• Language: English
• Subjects: Aged; Basement Membrane - surgery; Biological and medical sciences; Combined Modality Therapy; Eyes & eyesight; Female; Glucocorticoids - therapeutic use; Humans; Lens Implantation, Intraocular; Macular degeneration; Male; Medical sciences; Miscellaneous; Ophthalmology; Phacoemulsification; Prospective Studies; Retinal Perforations - drug therapy; Retinal Perforations - physiopathology; Retinal Perforations - surgery; Retinopathies; Standard deviation; Surgery; Tomography, Optical Coherence; Triamcinolone Acetonide - therapeutic use; Visual Acuity - physiology; Vitrectomy - methods
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2007.09.035

Purpose To investigate whether triamcinolone acetonide in the macular hole after surgery interferes with anatomic macular hole repair or visual acuity improvement. Design Prospective, interventional case series with historical comparison. Methods Pars plana vitrectomy and triamcinolone acetonide-assisted internal limiting membrane peeling were performed in 26 eyes (24 patients) with stage 3 or 4 idiopathic macular hole. The visual acuities one-year after surgery were compared between eyes with and without residual triamcinolone acetonide after surgery. Results The macular holes were closed successfully in all 26 eyes. Nine eyes (35%) had residual triamcinolone acetonide in the macular hole at the end of the surgery and in the fovea on day 3 after surgery. The mean preoperative logarithm of the minimum angle of resolution (logMAR) visual acuity ± standard deviation was 0.73 ± 0.36 and improved significantly to 0.20 ± 0.29 one-year after surgery ( P = .010). In the nine eyes with residual triamcinolone acetonide, the preoperative mean logMAR triamcinolone acetonide was 0.81 ± 0.33, which improved to 0.20 ± 0.19 one-year after surgery ( P = .013). In the remaining 17 eyes, the mean visual acuity also improved from 0.71 ± 0.38 before surgery to 0.21 ± 0.28 after surgery ( P = .001). No significant difference was found between the groups in preoperative and postoperative logMAR visual acuities. Conclusions Residual triamcinolone acetonide in the macular hole does not interfere with anatomic or visual improvement.