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Pars plana vitrectomy with intravitreal triamcinolone: effect on uveitic cystoid macular oedema and treatment limitations
  1. Matthias Gutfleisch,
  2. Georg Spital,
  3. Anne Mingels,
  4. Daniel Pauleikhoff,
  5. Albrecht Lommatzsch,
  6. Arnd Heiligenhaus
  1. Department of Ophthalmology, St Franziskus Hospital, Hohenzollernring, Muenster, Germany
  1. Correspondence to: Professor A Heiligenhaus Department of Ophthalmology, St Franziskus Hospital, Hohenzollernring 74, 48145 Muenster, Germany; arnd.heiligenhaus{at}uveitis-zentrum.de

Abstract

Objective: To investigate the effect of pars plana vitrectomy (PPV) in combination with intraoperative intravitreal triamcinolone acetonide injection on the course of cystoid macular oedema (CME) in patients with uveitis.

Methods: Patients with uveitis with CME (n = 19) not responding to systemic corticosteroids and/or immunosuppression combined with acetazolamide were retrospectively studied after PPV with additional intravitreal injection of 4 mg triamcinolone acetonide. Patients had chronic anterior uveitis (n = 4), intermediate uveitis (n = 9), posterior uveitis (n = 3) or panuveitis (n = 3). Visual acuity tests, tonometry, fluorescein angiographic appearance and postoperative complications were analysed. Mean follow-up was 14 months (SD 4.6).

Results: CME improved in 58% of the patients within the first 6 weeks postoperatively. After 12 months, CME was further improved in 44% and worsened in another 12%. Improvement of visual acuity was noted in 42% after 3 months and in 28% after 12 months. Cataract progressed in 85% of the phacic patients postoperatively. Increased intraocular pressure was detected in 27% at 2 weeks and in 11% at 12 months after surgery.

Conclusion: Uveitic CME that is unresponsive to systemic immunosuppression and acetazolamide may improve after PPV with additional intravitreal triamcinolone application. The effect seems to be transient in many of the patients. Frequent complications were cataract formation and ocular hypertension.

  • CME, cystoid macular oedema
  • ILM, internal limiting membrane
  • IOP, intraocular pressure
  • PPV, pars plana vitrectomy

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Footnotes

  • Published Online First 27 September 2006

  • Competing interests: None declared.

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