Photo Credit: Albert_Karimov

The following is a summary of “Early use of intravitreal triamcinolone to inhibit traumatic proliferative vitreoretinopathy: a randomized clinical trial,” published in the November 2023 issue of Opthalmology by Guo et al.

Researchers started a retrospective study to evaluate the effectiveness of intravitreal injection of triamcinolone acetonide (TA) after emergency surgery for open globe injury (OGI) in preventing traumatic proliferative vitreoretinopathy (TPVR).

They conducted a single-center, participant-masked, prospective, randomized, controlled clinical trial. Sixty-eight patients with globe rupture in zone III were randomly assigned to either the control group (n=34) or the TA group (n=34) in a 1:1 allocation ratio. After emergency surgery, patients in the TA group received 0.1 mL TA, while those in the control group received 0.1 mL balanced salt solution. The primary outcome assessed was TPVR during vitrectomy 10±3 days later. Secondary outcomes included visual acuity (VA), retinal attachment rate, macular attachment rate, proliferative vitreoretinopathy (PVR) recurrent rate, and side effects 6 months post-vitrectomy.

The results showed a significantly more severe TPVR grade during vitrectomy in the control group compared to the TA group (P=0.028). In terms of TPVR score, the TA group (9.30±0.82) demonstrated a significantly better outcome than the control group (6.44±1.06) (P=0.036). Final VA improvement was observed in 92% of eyes in the TA group, contrasting with 63.64% in the control group (P=0.008). Retinal attachment rates were 88% for the TA group and 63.64% for the control group (P=0.049). Both groups exhibited no significant differences in macular repositioning and PVR recurrent rate (P=0.215, 0.191). Following emergency surgery, temporary intraocular pressure elevation occurred in one eye in the TA group.

They concluded that early intravitreal TA injection reduced TPVR and improved visual outcomes for open globe injury.

Source: bjo.bmj.com/content/early/2023/11/28/bjo-2023-324318