Clinical effects of 23-gauge micro-invasive vitrectomy combined with triamcinolone acetonide on the treatment for proliferative diabetic retinopathy

Abstract

Objective To study the safety and efficacy of 23-gauge micro-invasive vitrectomy combined with posterior sub-Tenoncapsule injection of triamcinolone acetonide (PSTA) in treating proliferative diabetic retinopathy (PDR). Methods The clinical data of 46 patients with PDR (48 eyes) from June 2014 to June 2016 in Department of Ophthalmology, Huaian Hospital of Xuzhou Medical College were retrospectively analyzed. Pars plana vitrectomy combined with triamcinolone acetonide (TA) was performed on 48 eyes suffered from proliferative diabetic retinopathy and 8 mg of TA was injected into the eyes for dying of vitreous during the operations and 30mg of TA was injected in the posterior sub-Tenon capsule. Postoperatively, the best corrected visual acuity (BCVA), intraocular pressure (IOP), changes of macular central fovea thickness, intraoperative and postoperative complications were observed. Results The BCVA was improved in 36 eyes (75%) after 3mo and 28 eyes (58.33%) after 6mo, there was statistical difference with preoperative (P 0.05). Macula central fovea thickness was 296.05±51.71, 277.15±41.24, 254.83±33.62, and 226.47±28.56um at 7d, 1, 3 and 6mo respectively. The differences had statistically significant at 7d, 1, 3 and 6mo compared with preoperative 433.52±101.03um (P <0.05). Intraoperative complications: 5 eyes (10.42%) happened latrogenic tear hole, 11 eyes (22.92%8%) happened retinal hemorrhage; Postoperative complications: 8 eyes (16.67%) found hyphema, 7 eyes (14.58%) presented fundus hemorrhage. Conclusions 23-gauge micro-invasive vitrectomy combined with posterior sub-Tenon capsule injection of triamcinolone acetonide in treating proliferative diabetic retinopathy is safe and effective, and the patients can reduce macular edema and improve visual acuity. Key words: 23-gauge micro-invasive vitrectomy; Proliferative diabetic retinopathy; Triamcinolone acetonide (TA); Dying of vitreous; Posterior sub-Tenon capsule injection