Preservative-free corticosteroid aids visualization during pars plana vitrectomy

Retina. 2009;29(1):38-45.

A preservative-free triamcinolone acetonide injectable suspension facilitated visualization of the posterior segment during pars plana vitrectomy.

"Greater than 90% of surgeon evaluations agreed or strongly agreed that preservative-free triamcinolone enhanced visualization of posterior segment structures," the study authors said. "No safety issues were identified."

The phase 3, observer-masked study conducted at six centers by 10 surgeons included 60 patients scheduled to undergo pars plana vitrectomy. Up to 4 mg of preservative-free Triesence (triamcinolone acetonide injectable suspension, Alcon) was injected into each eye to assist surgeons' visualization of the vitreous and surrounding membranes.

Intraoperative video recordings showed visualization before and after instillation of triamcinolone. A masked observer rated visualization on a five-point scale ranging from "not visible" (a score of 0) to "clearly delineated" (a score of 4). Also, surgeons used a subjective five-point scale ("strongly agree" to "strongly disagree") to evaluate visualization.

The masked observer gave visualization of posterior segment structures higher ratings after installation of triamcinolone in 59 of 60 cases. The mean pre-installation visualization score was 0.5. The mean post-installation score was 3.7. The difference was statistically significant (P < .0001), the authors said.