P 171Intravitreal injection of cristalline cortisone as adjunctive treatment in early phthisis bulbi
J. K. Hayler, J. B. Jonas
Purpose: To report on clinical outcome and complication after intravitreal injection of cristalline cortisone in patients with early phthisis bulbi.
Patients and Methods: Two patients presented with chronic ocular hypo-tony and early phthisis bulbi characterized by corneal edema and corneal neovascularisation, absent anterior chamber, and intraocular pressure readings lower than 2 mm Hg. The first patient with almost absolute pri-mary open-angle glaucoma had experienced a traumatic rupture of his eye with consequent expulsive hemorrhage. By pars plana vitrectomy, the su-prachoroidal hemorrhage was removed and the remaining remnants of the retina were re-attached by silicone oil endotamponade. Due to the expul-sion of intraocular tissue, half of the fundus showed bared sclera without choroid or retina. The second patient underwent macula rotation with peri-pheral circumferential retinorhexis and silicone oil endotamponade after radiotherapy had been unsuccesful in treatment of age-related macular degeneration. Ten weeks after surgery, he presented with an edematous and vascularized cornea, intraocular pressure lower than 2 mm Hg, and the anterior chamber was not detectable upon slit lamp examination. In both patients, about 20 mg of cristalline steroid (triamcinolonacetonid) were injected intravitreally in topical anesthesia. The follow-up time after the injection was 3 and 5 weeks.
Results: In both patients, intraocular pressure rose postoperatively to va-lues between 6 and 14 mm Hg. The corneal neovascularization almost completely regressed, and the cornea markedly cleared up. Toxic side effects and decrease of visual acuity were not detected.
Discussion: The results obtained so far after a short follow-up time sug-gest that the intravitreal injection of cristalline cortisone may be an additive tool in the treatment of early phthisis bulbi.
Dept. Ophthalmology Univ. Erlangen-Nürnberg, Schwabachanlage 6, D-91054 Erlangen