Intravitreal triamcinolone acetonide versus pars plana vitrectomy for pseudophakic cystoid macular edema

To compare the efficacy of intravitreal triamcinolone acetonide injection versus 23-gauge pars plana vitrectomy with internal limiting membrane peeling for the treatment of chronic pseudophakic cystoid macular edema (CME) after uncomplicated cataract surgery.

This retrospective, comparative, consecutive case series study included 39 patients with chronic pseudophakic CME. Twenty eyes in 20 patients were treated with intravitreal triamcinolone acetonide injection (IVT group), and 19 eyes in 19 patients were treated with pars plana vitrectomy with internal limiting membrane peeling (PPV group). In both groups, complete ophthalmologic examinations were performed before and after procedures. Findings were compared between the groups.

Both groups experienced a significant improvement in visual acuity and macular thickness after 12 months follow-up. At months 1 and 2, the IVT group showed a significant improvement in visual acuity and a significant reduction in macular thickness compared with the PPV group (p < 0.05), but these differences were not statistically significant between the groups after the 12-month period.

Both intravitreal steroid injection and pars plana vitrectomy with internal limiting membrane peeling had a favorable effect on visual and anatomic results in patients with chronic pseudophakic CME. However, surgical treatment had no advantage over intravitreal triamcinolone acetonide injection after 12-months follow-up.