Efficacy of retrobulbar triamcinolone acetonide after vitrectomy combined with intraocular lens fixation for intraocular lens dislocation with cystoid macular edema
Objective To explore the effect of retrobulbar triamcinolone acetonide(TA)after pars planavitrectomy(PPV)com-bined with intraocular lens(IOL)fixation for IOL dislocation with cystoid macular edema(CME).Design Retrospective case series.Participants 19 patients(19 eyes)with IOL dislocation and CME were included from January 2020 to January 2024 in Beijing Tongren Hospital.Methods All cases underwent routine ophthalmic examination before surgery,including uncorrected visual acuity(UCVA)and best corrected visual acuity(BCVA),intraocular pressure(IOP),fundus examination,fundus fluorescein angiography,OCT and central macular thickness(CMT)measurement.The surgical methods for all included eyes were vitrectomy combined with IOL fixation,and TA(20 mg)retrobulbar injection after the surgery immediately.All patients underwent routine postoperative follow-up at 1,3,7 days,1,3 months and above after surgery.Main Outcome Measures BCVA,IOP,CMT,recurrence of CME,and complications.Results The postoperative follow-up time was(7.05±3.26)months(4-15 months).BCVA(LogMAR)at 1 month,3 months after surgery,and final fol-low-up was(0.11±0.09),(0.07±0.13),(0.09±0.19),compared with the preoperative BCVA(LogMAR)(0.52±0.21),which was all signifi-cantly decreased(all P＜0.001).The IOP at 1 month,3 months after surgery,and final follow-up was(18.06±3.11)mmHg,(17.61±2.17)mmHg,(17.00±2.93)mmHg,compared with the preoperative IOP(16.94±3.42)mmHg,which was all without significant difference.The CMT at 1 month,3 months after surgery,and the last follow-up was(289.84±37.30)μm,(295.16±107.75)μm,(300.53±125.37)μm,compared with that before surgery(451.47±140.71)μm,which was all significantly decreased(all P＜0.001).The CME in 15.8％(3/19 cases)reappeared at least 1 time during the follow-up.No serious complications such as vitreous hemorrhage,retinal detachment,infec-tious endophthalmitis,and IOL redislocation occurred in all the eyes during surgery and follow-up.The incidence of intraocular hyper-tension was 5.3％(1/19 cases)1 month after surgery,and the IOP of this eye was normal 3 months after surgery.Conclusion Retrobul-bar TA injection after the vitrectomy combined with IOL fixation is a safe and effective treatment for IOL dislocation with CME.(Oph-thalmol CHN,2024,33:301-306)
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