Surgical Removal of Sub-Tenon Triamcinolone Acetonide in Cases of Increased Intraocular Pressure after Sub-Tenon Injection

Sang Won Ha; Myoung Jun Kim; Dong Ho Park; Si Yeol Kim; Jae Pil Shin

doi:10.3341/jkos.2012.53.1.175

Journal List > J Korean Ophthalmol Soc > v.53(1) > 1009249

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Ha, Kim, Park, Kim, and Shin: Surgical Removal of Sub-Tenon Triamcinolone Acetonide in Cases of Increased Intraocular Pressure after Sub-Tenon Injection

Original Article

J Korean Ophthalmol Soc 2012;53(1):175-179.

Published online: 7 September 2012

DOI: https://doi.org/10.3341/jkos.2012.53.1.175

Surgical Removal of Sub-Tenon Triamcinolone Acetonide in Cases of Increased Intraocular Pressure after Sub-Tenon Injection

Sang Won Ha, MD, Myoung Jun Kim, MD, Dong Ho Park, MD, PhD, Si Yeol Kim, MD, PhD, Jae Pil Shin, MD, PhD

Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, Korea

Address reprint requests to Jae Pil Shin, MD, PhD Department of Ophthalmology Kyungpook National University Hospital #130 Dongdeok-ro Jung-gu Daegu 700-721 Korea Tel 82-53-420-5801 Fax 82-53-426-6552 E-mail: jps11@hanmail.net

Received 28 March 201124 May 2011 Accepted 18 November 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report cases of the surgical removal of sub-Tenon triamcinolone acetonide to control increased intraocular pressure after sub-Tenon triamcinolone acetonide injection

Case summary

Three patients had no response to maximal medical treatment to control suddenly increased intraocular pressure after sub-Tenon triamcinolone acetonide (40 mg) injection to treat diabetic macular edema. The anterior chamber angle was open in all patients, and there was no neovascularization in the iris or anterior chamber angle. Slit lamp bio-microscopy showed deposition of triamcinolone acetonide in the inferior sub-Tenon area. Intraocular pressure was decreased within the normal range without any medication after removal of triamcinolone acetonide precipitates.

Conclusions

Surgical removal of sub-Tenon triamcinolone acetonide can be as a primary treatment option in cases of increased intraocular pressure which shows no response to maximal medical treatment after sub-Tenon triamcinolone acetonide injection.

Keywords: Diabetic macular edema, Intraocular pressure, Triamcinolone acetonide

References

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Figure 1.

Slit lamp biomicroscopy shows precipitates of triamcinolone acetonide in the inferior sub-Tenon after injection of sub-Tenon triamcinolone acetonide.

Figure 2.

Sub-Tenon triamcinolone acetonide and Tenon's capsule is removed with forceps and tenotomy scissors after dissection of the conjunctiva.

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