The Intraocular Use of Triamcinolone Acetonide in Controlling Intraoperative Bleeding During Vitrectomy for Proliferative Diabetic Retinopathy



To observe the efficacy and safety of intraocular use of triamcinolone acetonide in controlling intraoperative bleeding during vitrectomy for proliferative diabetic retinopathy, and to analyze the relative factors.


We reviewed 25 patients (29 eyes) with severe proliferative diabetic retinopathy who experienced intraoperative bleeding during vitrectomy and ongoing peeling of epiretinal membrane. TA (4 mg, 0.1 ml) was promptly applied over the bleeding retina or proliferative membrane in these bleeding eyes. Data collected included condition of intra- and post- operative intraocular bleeding, postoperative visual acuity, intraocular pressure, and complications.


After TA injection, intraoperative bleeding was effectively controlled with visible TA precipitates along with blood clots formation on the bleeding retina or proliferative membrane surface. Eight eyes (27.6%) needed endocautery to prevent remnant but visible leaking vessels. Remnant epiretinal hemorrhage was not cleared in 9 eyes (31.0%) by week 1 and in 4 eyes (13.8%) by month 1 postoperatively. All eyes achieved both intraocular and retinal hemorrhage free condition on month 3 postoperatively. At 6 months after surgery, visual acuity improved in 25 eyes (86.2%). Postoperative intraocular pressure elevation occurred in 8 eyes (27.6%), including 1 eye (3.4%) required one successful trabeculectomy. No recurrent intraocular hemorrhage, proliferative membrane formation, endophthalmitis or other severe complications were observed during follow-up period.


Intraoperative TA injection over the bleeding retina vessels or proliferative membrane effectively controlled bleeding during vitrectomy, and facilitated surgeries with prompt clear visual field.



Hua Yan
Tianjin, China
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