Effect of Posterior Subtenon Triamcinolone Injection during Vitrectomy for Idiopathic Epiretinal Membrane

Kim Sung Il; Park Sung Who; Ik Soo Byon; Ji Eun Lee

doi:10.3341/jkos.2015.56.8.1236

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Sung Il, Sung Who, Byon, and Lee: Effect of Posterior Subtenon Triamcinolone Injection during Vitrectomy for Idiopathic Epiretinal Membrane

Original Article

J Korean Ophthalmol Soc 2015;56(8):1236-1241.

Published online: 29 August 2015

DOI: https://doi.org/10.3341/jkos.2015.56.8.1236

Effect of Posterior Subtenon Triamcinolone Injection during Vitrectomy for Idiopathic Epiretinal Membrane

Kim Sung Il, M.D¹, Park Sung Who, M.D¹, Ik Soo Byon, MD², Ji Eun Lee, MD, PhD^1,

Department of Ophthalmology, Pusan National University School of Medicine, Busan, Korea

Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea

Address reprint requests to Ji Eun Lee, MD, PhD Department of Ophthalmology, Pusan National University Hospital, #179 Gudeok-ro, Seo-gu, Busan 602-739, Korea Tel: 82-51-240-7326, Fax: 82-51-242-7341 E-mail: jlee@pusan.ac.kr

∗ This work was supported by clinical research grant from Pusan National University Hospital.

Received 8 November 201426 January 2015 Accepted 1 July 2015

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 evaluate the effect of posterior sub-Tenon triamcinolone acetonide injection combined with vitrectomy for idiopathic epiretinal membrane (ERM).

Methods

This study included 40 eyes of 40 patients who underwent vitrectomy and membrane peeling for idiopathic ERM. Triamcinolone acetonide (40 mg) was injected into the posterior sub-Tenon space following vitrectomy in 20 eyes of the injected group. The other 20 eyes that did not receive the injection were selected as the control group to match preoperative visual acuity and central macular thickness with the injected group. Pre- and postoperative best-corrected visual acuity, central macular thick-ness, intraocular pressure, and complications were compared between the 2 groups.

Results

The average visual acuity in the injected group improved from 0.56 ± 0.23 (log MAR) at baseline to 0.52 ± 0.36 at 1 month, 0.44 ± 0.39 at 3 months, and 0.38 ± 0.41 at 6 months postoperatively. Central macular thickness decreased from 456.2 ± 86.2 to 399.0 ± 60.1 at 1 month, 377.1 ± 71.5 at 3 months, and 353.1 ± 57.4 at 6 months postoperatively. In the control group, average vis-ual acuity improved from 0.56 ± 0.23 at baseline to 0.53 ± 0.25 at 1 month, 0.41 ± 0.20 at 3 months, and 0.37 ± 0.24 at 6 months postoperatively. Central macular thickness decreased from 456.4 ± 74.8 to 394.9 ± 63.5 at 1 month, 377.2 ± 56.8 at 3 months, and 358.0 ± 57.2 at 6 months postoperatively. Significant differences in visual acuity and central macular thickness were not observed between the 2 groups before surgery and during the follow-up period. Intraocular pressure and complications were similar.

Conclusions

Posterior sub-Tenon injection of triamcinolone acetonide combined with vitrectomy for idiopathic epiretinal mem-brane did not affect postoperative anatomical and functional outcomes.

Keywords: Idiopathic epiretinal membrane, Posterior sub-Tenon triamcinolone, Vitrectomy

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Figure 1.

Preoperative and postoperative best-corrected visual acuity after surgical removal of the epiretinal membrane with and without posterior sub-tenon triamcinolone acetonide injection. TA =triamcinolone acetonide. *Posterior sub-tenon triamcinolone acetonide was injected during vitrectomy; ^† Posterior sub-tenon triamcinolone acetonide was not injected during vitrectomy.

Figure 2.

Preoperative and postoperative foveal thickness (micrometers) after the surgical removal of the epiretinal membrane with and without posterior sub-tenon triamcinolone acetonide injection. TA = triamcinolone acetonide.

Figure 3.

Preoperative and postoperative intraocular pressure (mm Hg) after the surgical removal of the epiretinal membrane with and without posterior sub-tenon triamcinolone acetonide injection. TA = triamcinolone acetonide.

Table 1.

Baseline characteristics

Parameters	Injected group	Non-injected group	p-value
Sex (male:female)	9:11	6:14	0.51
Laterality (right:left)	9:11	12:8	0.53
Age (years)	64.0 ± 12.7	65.5 ± 7.7	0.62
Symptom duration (months)	4.5 ± 6.1	5.0 ± 4.6	0.81
Lens state (phakia:pseudophakia)	19:1	20:0	1.00
Combined cataract surgery	17	18	1.00
Lens save surgery	2	2
ILM peeling (yes:no)	15:5	16:4	1.00
BCVA (log MAR)	0.56 ± 0.23	0.56 ± 0.23	1.00
CSMT (μ m)	456.2 ± 86.2	456.4 ± 74.8	0.98

Values are presented as mean ± SD unless otherwise indicated. ILM = internal limiting membrane; BCVA = best corrected visual acuity, log MAR = logarithm of the minimum angle of resolution; CSMT = central subfield macular thickness.

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