Diabetic Retinopathy & Medical Retina - aioseducation

70th AIOC Proceedings, Cochin 2012
Post operative visual outcome after diabetic vitrectomy with the use of
adjunctive IVB were comparable to similar study conducted by di lauro et.
al. and Madarres et. al. A compromise in post surgery visual acuity was seen
in cases where silicon oil was used as the tamponade. A high percentage of
cataract formation was seen in silicon oil group and also TRD group. Vitreous
lavage was needed for 7 eyes belonging to gas and FAE groups but eyes with
silicon oil tamponade showed better anatomic and vascular stability.
In conslusion Pre operative IVB makes diabetic vitrectomy safer and effective
for severe PDR thereby enhancing the anatomical and visual outcomes.
Phacoemulsification with Intravitreal
Triamcinolone Acetonide Injection in Diabetic
Macular Edema and Cataract
Dr. Shikha Talwar Bassi, Dr. Ekta Rishi, Dr. Vineet Ratra, Dr. Jayant Kadaskar
Diabetic macular edema (DMO) is the main cause of poor visual recovery
after a cataract surgery in diabetics. 1,2 A study has reported an increased
aqueous levels of vascular endothelial growth factors and interleukin-6
postoperatively after a cataract surgery in diabetics which can cause a
worsening of the DMO. 3 Intravitreal corticosteroids have been documented
to reduce the diabetic macular oedema. 4,5 The inflammatory response to
the cataract surgery can be controlled with an intravitreal corticosteroid
injection during the cataract surgery. On this hypothesis studies have already
documented a reduction in the amount of increase in center- point thickness
after a cataract surgery with intravitreal corticosteroid injection. 6
MATERIALS AND METHODS
A retrospective analysis of 18 eyes of 13 diabetic patients with DMO and
significant cataract, who underwent phacoemulsification with intravitreal
triamcinolone injection (4 mg) during the surgery was done. Study was
carried out at tertiary care center in south India. All eyes had a preoperative
examination including measurement of visual acuity, intraocular pressure, A
scan biometry, a detailed slit lamp biomicroscopy under maximal mydriasis.
All patient were evaluated by optical coherence tomography before surgery.
Central Macular thickness (CMT) was noted preoperatively in all the
patients. After cataract surgery with phacoemulsification technique 4 mg of
triamcinolone acetonide was injected through pars plana 3.5 mm to 4.0 mm
posterior to limbus with 28 guage needle. All eyes were evaluated on first day,
third day and three weeks later after the surgery. Nine eyes underwent OCT
at three weeks visit, CMT was noted. The BCVA pre operatively and after 3
890