Intravitreal injection versus subtenon infusion of triamcinolone acetonide during cataract surgery in patients with refractory diabetic macular edema

Cléicio Takata, Andre Messias, Marco S. Folgosa, Levy R. Lucena, Daniel R. Lucena, Ingrid Scott, Rodrigo Jorge

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Purpose: The purpose of this study was to compare the effectiveness of intravitreal injection (IVT) versus posterior subtenon infusion (STI) of triamcinolone acetonide performed during phacoemulsification cataract surgery in eyes with refractory diffuse diabetic macular edema. Methods: Twenty-four eyes of 24 patients with refractory diffuse diabetic macular edema scheduled to undergo phacoemulsification cataract surgery were randomly assigned to receive either a 4-mg IVT (n = 12) or a 40-mg STI (n = 12) of triamcinolone acetonide during cataract surgery. Comprehensive ophthalmic evaluation, including best-corrected visual acuity, intraocular pressure, and central macular thickness measured with optical coherence tomography, was performed at baseline and at 1, 4, 8 ± 1, 12 ± 2, and 24 ± 2 weeks postoperatively. Results: Ten patients from the IVT group and 9 patients from the STI group completed the 24-week study visit. Mean baseline best-corrected visual acuity (logarithm of the minimum angle of resolution) was 20/259 and 20/222 in the IVT and STI groups, respectively (t = 0.41; P = 0.3407). A significant improvement in best-corrected visual acuity was observed only in the IVT group at 4 weeks (mean difference ± standard error, improved to 20/116; P = 0.0437), 8 weeks (20/110; P = 0.0355), and 12 weeks (20/121; P = 0.0471) postoperatively. There was no significant change from baseline in mean intraocular pressure in either group. Mean ± standard error baseline central macular thickness was 474.1 ± 42.4 μm and 490.8 ± 70.8 μm in the IVT and STI groups, respectively (t = 0.21; P = 0.5807). The central macular thickness reductions after surgery at all study follow-up visits were significantly greater in the IVT group than in the STI group (P < 0.05). Conclusion: These data suggest that IVT is more effective than STI of triamcinolone acetonide for the management of refractory diffuse diabetic macular edema in eyes undergoing phacoemulsification. Further investigation of a larger number of patients with longer follow-up is necessary to confirm these findings.

Original languageEnglish (US)
Pages (from-to)562-569
Number of pages8
JournalRetina
Volume30
Issue number4
DOIs
StatePublished - Jan 1 2010

Fingerprint

Triamcinolone Acetonide
Intravitreal Injections
Macular Edema
Cataract
Phacoemulsification
Visual Acuity
Intraocular Pressure
Optical Coherence Tomography

All Science Journal Classification (ASJC) codes

  • Ophthalmology

Cite this

Takata, Cléicio ; Messias, Andre ; Folgosa, Marco S. ; Lucena, Levy R. ; Lucena, Daniel R. ; Scott, Ingrid ; Jorge, Rodrigo. / Intravitreal injection versus subtenon infusion of triamcinolone acetonide during cataract surgery in patients with refractory diabetic macular edema. In: Retina. 2010 ; Vol. 30, No. 4. pp. 562-569.
@article{84633a8b1c7f4be7b0ea1dd7dfe14bfd,
title = "Intravitreal injection versus subtenon infusion of triamcinolone acetonide during cataract surgery in patients with refractory diabetic macular edema",
abstract = "Purpose: The purpose of this study was to compare the effectiveness of intravitreal injection (IVT) versus posterior subtenon infusion (STI) of triamcinolone acetonide performed during phacoemulsification cataract surgery in eyes with refractory diffuse diabetic macular edema. Methods: Twenty-four eyes of 24 patients with refractory diffuse diabetic macular edema scheduled to undergo phacoemulsification cataract surgery were randomly assigned to receive either a 4-mg IVT (n = 12) or a 40-mg STI (n = 12) of triamcinolone acetonide during cataract surgery. Comprehensive ophthalmic evaluation, including best-corrected visual acuity, intraocular pressure, and central macular thickness measured with optical coherence tomography, was performed at baseline and at 1, 4, 8 ± 1, 12 ± 2, and 24 ± 2 weeks postoperatively. Results: Ten patients from the IVT group and 9 patients from the STI group completed the 24-week study visit. Mean baseline best-corrected visual acuity (logarithm of the minimum angle of resolution) was 20/259 and 20/222 in the IVT and STI groups, respectively (t = 0.41; P = 0.3407). A significant improvement in best-corrected visual acuity was observed only in the IVT group at 4 weeks (mean difference ± standard error, improved to 20/116; P = 0.0437), 8 weeks (20/110; P = 0.0355), and 12 weeks (20/121; P = 0.0471) postoperatively. There was no significant change from baseline in mean intraocular pressure in either group. Mean ± standard error baseline central macular thickness was 474.1 ± 42.4 μm and 490.8 ± 70.8 μm in the IVT and STI groups, respectively (t = 0.21; P = 0.5807). The central macular thickness reductions after surgery at all study follow-up visits were significantly greater in the IVT group than in the STI group (P < 0.05). Conclusion: These data suggest that IVT is more effective than STI of triamcinolone acetonide for the management of refractory diffuse diabetic macular edema in eyes undergoing phacoemulsification. Further investigation of a larger number of patients with longer follow-up is necessary to confirm these findings.",
author = "Cl{\'e}icio Takata and Andre Messias and Folgosa, {Marco S.} and Lucena, {Levy R.} and Lucena, {Daniel R.} and Ingrid Scott and Rodrigo Jorge",
year = "2010",
month = "1",
day = "1",
doi = "10.1097/IAE.0b013e3181c969b4",
language = "English (US)",
volume = "30",
pages = "562--569",
journal = "Retina",
issn = "0275-004X",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

Intravitreal injection versus subtenon infusion of triamcinolone acetonide during cataract surgery in patients with refractory diabetic macular edema. / Takata, Cléicio; Messias, Andre; Folgosa, Marco S.; Lucena, Levy R.; Lucena, Daniel R.; Scott, Ingrid; Jorge, Rodrigo.

In: Retina, Vol. 30, No. 4, 01.01.2010, p. 562-569.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Intravitreal injection versus subtenon infusion of triamcinolone acetonide during cataract surgery in patients with refractory diabetic macular edema

AU - Takata, Cléicio

AU - Messias, Andre

AU - Folgosa, Marco S.

AU - Lucena, Levy R.

AU - Lucena, Daniel R.

AU - Scott, Ingrid

AU - Jorge, Rodrigo

PY - 2010/1/1

Y1 - 2010/1/1

N2 - Purpose: The purpose of this study was to compare the effectiveness of intravitreal injection (IVT) versus posterior subtenon infusion (STI) of triamcinolone acetonide performed during phacoemulsification cataract surgery in eyes with refractory diffuse diabetic macular edema. Methods: Twenty-four eyes of 24 patients with refractory diffuse diabetic macular edema scheduled to undergo phacoemulsification cataract surgery were randomly assigned to receive either a 4-mg IVT (n = 12) or a 40-mg STI (n = 12) of triamcinolone acetonide during cataract surgery. Comprehensive ophthalmic evaluation, including best-corrected visual acuity, intraocular pressure, and central macular thickness measured with optical coherence tomography, was performed at baseline and at 1, 4, 8 ± 1, 12 ± 2, and 24 ± 2 weeks postoperatively. Results: Ten patients from the IVT group and 9 patients from the STI group completed the 24-week study visit. Mean baseline best-corrected visual acuity (logarithm of the minimum angle of resolution) was 20/259 and 20/222 in the IVT and STI groups, respectively (t = 0.41; P = 0.3407). A significant improvement in best-corrected visual acuity was observed only in the IVT group at 4 weeks (mean difference ± standard error, improved to 20/116; P = 0.0437), 8 weeks (20/110; P = 0.0355), and 12 weeks (20/121; P = 0.0471) postoperatively. There was no significant change from baseline in mean intraocular pressure in either group. Mean ± standard error baseline central macular thickness was 474.1 ± 42.4 μm and 490.8 ± 70.8 μm in the IVT and STI groups, respectively (t = 0.21; P = 0.5807). The central macular thickness reductions after surgery at all study follow-up visits were significantly greater in the IVT group than in the STI group (P < 0.05). Conclusion: These data suggest that IVT is more effective than STI of triamcinolone acetonide for the management of refractory diffuse diabetic macular edema in eyes undergoing phacoemulsification. Further investigation of a larger number of patients with longer follow-up is necessary to confirm these findings.

AB - Purpose: The purpose of this study was to compare the effectiveness of intravitreal injection (IVT) versus posterior subtenon infusion (STI) of triamcinolone acetonide performed during phacoemulsification cataract surgery in eyes with refractory diffuse diabetic macular edema. Methods: Twenty-four eyes of 24 patients with refractory diffuse diabetic macular edema scheduled to undergo phacoemulsification cataract surgery were randomly assigned to receive either a 4-mg IVT (n = 12) or a 40-mg STI (n = 12) of triamcinolone acetonide during cataract surgery. Comprehensive ophthalmic evaluation, including best-corrected visual acuity, intraocular pressure, and central macular thickness measured with optical coherence tomography, was performed at baseline and at 1, 4, 8 ± 1, 12 ± 2, and 24 ± 2 weeks postoperatively. Results: Ten patients from the IVT group and 9 patients from the STI group completed the 24-week study visit. Mean baseline best-corrected visual acuity (logarithm of the minimum angle of resolution) was 20/259 and 20/222 in the IVT and STI groups, respectively (t = 0.41; P = 0.3407). A significant improvement in best-corrected visual acuity was observed only in the IVT group at 4 weeks (mean difference ± standard error, improved to 20/116; P = 0.0437), 8 weeks (20/110; P = 0.0355), and 12 weeks (20/121; P = 0.0471) postoperatively. There was no significant change from baseline in mean intraocular pressure in either group. Mean ± standard error baseline central macular thickness was 474.1 ± 42.4 μm and 490.8 ± 70.8 μm in the IVT and STI groups, respectively (t = 0.21; P = 0.5807). The central macular thickness reductions after surgery at all study follow-up visits were significantly greater in the IVT group than in the STI group (P < 0.05). Conclusion: These data suggest that IVT is more effective than STI of triamcinolone acetonide for the management of refractory diffuse diabetic macular edema in eyes undergoing phacoemulsification. Further investigation of a larger number of patients with longer follow-up is necessary to confirm these findings.

UR - http://www.scopus.com/inward/record.url?scp=77951162006&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77951162006&partnerID=8YFLogxK

U2 - 10.1097/IAE.0b013e3181c969b4

DO - 10.1097/IAE.0b013e3181c969b4

M3 - Article

C2 - 20182403

AN - SCOPUS:77951162006

VL - 30

SP - 562

EP - 569

JO - Retina

JF - Retina

SN - 0275-004X

IS - 4

ER -