Intravitreal injection of crystalline cortisone as adjunctive treatment ofproliferative vitreoretinopathy

Aim-To report on clinical outcome and complications of intravitreal injecti on of crystalline cortisone in patients undergoing pars plana vitrectomy fo r treatment of proliferative vitreoretinopathy. Methods-The study included all 16 patients who underwent pars plana vitrect omy for treatment of proliferative vitreoretinopathy, who received an intra vitreal injection of 10-20 mg crystalline triamcinolone acetonide at the en d of surgery, and who were operated on by the same surgeon. Most of the veh icle of the solution containing the cortisone crystals was removed before p erforming the injection. Mean follow up time was 1.64 (SD 2.15) months (med ian 1.23 months; range 0.20-9.20 months). The study group was compared with a control group which consisted of 144 patients undergoing pars plana vitr ectomy for proliferative vitreoretinopathy performed by the same surgeon. Results-In the study group compared with the control group, intraocular inf lammation, as estimated clinically by slit lamp biomicroscopy, was lower, a ppearance of the fundus upon ophthalmoscopy in the first postoperative week was clearer, and postoperative pain in the first two postoperative days wa s reduced. Intraocular pressure measured at the end of the first postoperat ive week did not vary significantly between the groups. A pseudohypopyon co nsisting of cortisone crystals in the inferior anterior chamber angle was d etected in one patient. Postoperative infectious endophthalmitis was not en countered. Conclusions-This pilot study suggests that intravitreal injection of crysta lline cortisone with most of the vehicle removed is not toxic to intraocula r structures, reduces postoperative intraocular inflammation, and may be a potentially useful additional tool in the treatment of proliferative vitreo retinopathy.