Application of the mixture of sodium hyaluronate gel and triamcinolone acetonide in intraocular surgery

Objective To observe the efficacy of application of the mixture of sodium hyaluronate gel and triamcinolone acetonide(TA) in complex vitreoretinal surgery. Methods Prospective study. Total of 80 eyes of 77 patients who underwent complex vitreoretinal surgery combined with silicone oil tamponade in the First Affiliated Hospital of Zhengzhou University from May to Oct. 2018 were collected. All cases were randomly divided into treatment group and control group. At the end of surgery, the 1∶1 mixture 0.1 ml of sodium hyaluronate gel and TA (2 mg) was injected into the vitreous cavity in the treatment group; while the control group received injection of 2 mg TA into the vitreous cavity. Results The distribution of mixture was more uniform and diffuse in the silicone oil eye of treatment group, while the distribution of TA in control group was more concentrated in lumps in the silicone oil eye. The particles of TA could be completely absorbed within 2 weeks in the treatment group, while in control group TA retained for 4-8 weeks. The early postoperative BCVA improvement rate was 88.89% in the treatment group and 43.18% in control group, respectively. The difference of BCVA improvement rate was statistically significant between the two groups (χ2=19.067, P=0.000). The incidence of intraocular hypertension was 30.56% (11/36) in the treatment group and 29.55% (13/44) in control group, respectively (χ2=0.010, P=0.557). The incidence of anterior chamber fibrin exudation in the two groups was 22.22%(8/36) and 15.91% (7/44), respectively(χ2=0.518, P=0.472). The incidence of proliferative vitreoretinopathy(PVR) in the two groups was 38.89% (14/36) and 38.64% (17/44), respectively(χ2=0.001, P=0.581). Conclusion The mixture of sodium hyaluronate gel and TA is more evenly distributed and absorbed faster in the silicone oil tamponade eye. It is more conducive to the early postoperative visual recovery and fundus observation. Key words: Surgery, vitreoretinal, complex; Vitreoretinopathy, proliferative; Sodium hyaluronate; Triamcinolone acetonide; Hypertension; Anterior chamber exudation