曲安奈德眼内注射联合格栅样光凝治疗视网膜静脉阻塞黄斑囊样水肿短期疗效观察

目的:观察曲安奈德玻璃体腔注射联合黄斑区格栅样光凝治疗视网膜静脉阻塞黄斑囊样水肿的效果.方法:视网膜静脉阻塞合并黄斑囊样水肿的患者40例40眼,其中治疗组20例20眼给予曲安奈德2mg玻璃体腔注射,lwk后行黄斑区格栅样光凝治疗;另外对照组20例20眼行单纯曲安奈德2mg眼内注射.通过OCT测量黄斑区视网膜的厚度以分析治疗前后黄斑囊样水肿的吸收情况和视力的改善情况.结果:治疗组患者治疗前黄斑区视网膜平均厚度为412.67±133.04μm,治疗后3mo为281.63±59.39μm;对照组治疗前黄斑区视网膜的平均厚度为409.58±131.96μm,治疗后3mo为358.72±116.17μm,治疗后两组患者间黄斑区的视网膜厚度变化差异有统计学意义(t=8.97,P=0.003 ＜0.05).治疗组3mo后有4眼患者黄斑囊样水肿复发,再次行曲安奈德眼内注射;对照组3 mo后有12眼黄斑水肿复发,再次行眼内曲安奈德注射治疗.卡方检验比较两组患者间复发病例,差异有统计学意义(x2=6.50,P=0.022＜0.05).结论:曲安奈德玻璃体腔注射联合黄斑区格栅样光凝治疗静脉阻塞黄斑囊样水肿疗效显著,患者视力有所提高,并且较少复发.     

不同剂量IVTA治疗葡萄膜炎黄斑囊样水肿的疗效观察

目的:观察两种不同剂量曲安奈德玻璃体腔注射(intravitreal triamcinolone acetonide,IVTA)治疗葡萄膜炎黄斑囊样水肿的效果,并对其治疗结果和并发症情况进行比较。方法:分析研究2010-01/2012-01在我院确诊为双眼葡萄膜炎黄斑囊样水肿的患者6例12眼,每例患者双眼随机分为A,B两组进行曲安奈德玻璃体腔注射治疗,A组玻璃体腔注射4mg曲安奈德,B组玻璃体腔注射2mg曲安奈德。术后观察两组视力、眼压、黄斑中心凹厚度、晶状体透明度以及葡萄膜炎复发等。数据比较采用配对t检验。结果:术后视力均有大幅提高,术后OCT显示12眼(100%)黄斑囊样水肿均消失,黄斑中心凹厚度减低,与术前相比差异有统计学意义(P<0.01)。术前与术后两组间视力、黄斑区厚度相比差异无统计学意义(P>0.05)。两组术后各出现眼压升高3例3眼(50%),A组药物控制后眼压平均为44.33±7.51mmHg,B组为23.33±2.52mmHg,术后两组间眼压差异有统计学意义(P=0.01)。2例患者双眼随访期间发生并发性白内障,2例患者双眼葡萄膜炎黄斑囊样水肿复发。结论:IVTA是治疗葡萄膜炎黄斑囊样水肿的有效方法。并发症有眼压升高和并发性白内障。玻璃体腔注射4mg和2mg曲安奈德治疗葡萄膜炎黄斑囊样水肿的疗效相同,后者眼压升高的并发症易于应用药物控制。     

曲安奈德玻璃体腔注射的并发症

曲安奈德（Triamcinolone acetonide TA）作为一种长效皮质类固醇激素已在眼科得到广泛应用，给药方式主要包括结膜下注射、Tenon，s囊下注射和球后注射，但由于治疗部位的有效浓度低、治疗效果不明显使这些给药方式受到一定的限制。近两年来，玻璃体腔注射曲安奈德（Intravitreal Triamcinolone acetonide IVTA）由于局部药物浓度高已得到推广。玻璃体腔注射曲安奈德主要用于治疗各种内眼性、新生血管性、增殖性或水肿性疾病，诸如弥漫性糖尿病黄斑水肿，视网膜静脉阻塞所致黄斑水肿，增殖性糖尿病视网膜病变，增殖性玻璃体视网膜病变，年龄相关性黄斑变性所致视网膜下新生血管，慢性早期结核性低眼压∥慢性葡萄膜炎和白内障术后持续性黄斑囊样水肿。曲安奈德确切的治疗机制虽尚不清楚，但是有几个假说，例如降低局部炎症介质，使钙通道上调，降低血管内皮生长因子的浓度，改善血——网膜屏障的功能。目前国内外已在广泛应用玻璃体腔注射曲安奈德，临床效果也很明显，但与此相关的并发症也有报道。玻璃体腔注射曲安奈德的并发症主要分为两类：手术相关性并发症和激素相关性并发症。     

玻璃体腔内注射曲安奈德治疗黄斑水肿的临床观察

目的观察玻璃体腔注射曲安奈德治疗黄斑水肿的疗效。方法对29例(31只眼)黄斑水肿患者行玻璃体腔内注射曲安奈德后定期随访半年,观察治疗前后视力、眼压及眼底黄斑区改变情况。结果全部患者玻璃体腔内注射曲安奈德后视力比术前提高,黄斑水肿消退或减轻。结论玻璃体腔内注射曲安奈德可消除黄斑水肿,提高视力,但远期效果及其对视网膜的毒性反应有待进一步研究。     

曲安奈德玻璃体腔注射联合黄斑格栅样光凝治疗黄斑水肿的临床研究

背景 糖皮质激素玻璃体腔注射治疗黄斑水肿的临床效果已得到证实,其代表性药物为曲安奈德.但曲安奈德局部应用联合黄斑格栅样光凝治疗黄斑水肿的疗效及安全性值得关注. 目的 评价曲安奈德玻璃体腔注射联合黄斑格栅样光凝治疗黄斑水肿的疗效及安全性. 方法 采取队列研究试验设计,按照纳入标准收集糖尿病性黄斑水肿或视网膜静脉阻塞性黄斑水肿患者120例120眼,按随机数字表法将患者随机分为试验组和对照组,两组人口基线特征匹配.试验组实施玻璃体腔注射曲安奈德联合黄斑格栅样光凝,对照组仅行黄斑格栅样光凝,分别于术后1周,1、3、6个月行最佳矫正视力、眼压、光学相干断层扫描(OCT)、荧光素眼底血管造影(FFA)检查,对检查指标进行组间比较,对试验组术后检测结果与术前值进行比较.结果 与玻璃体腔注射前视力比较,试验组在注射后1周、1、3、6个月视力均有明显提高,差异均有统计学意义(均P=0.000),而对照组治疗后各时间点的视力与治疗前比较差异均无统计学意义(P＞0.05);治疗后各时间点对照组的视力均明显低于试验组,差异均有统计学意义(P=0.037、0.000、0.002、0.046).玻璃体腔注射后各时间点试验组黄斑水肿明显减轻,黄斑中心凹视网膜神经上皮层厚度明显下降,差异均有统计学意义(均P=0.000),而对照组黄斑中心凹视网膜神经上皮层厚度与治疗前比较差异均无统计学意义(P＞0.05),玻璃体腔注射后各时间点试验组黄斑中心凹视网膜神经上皮层厚度均显著低于对照组,差异均有统计学意义(P＜0.05).试验组中7例在玻璃体腔注射后4～6个月黄斑水肿复发,占11.67％;玻璃体腔注射后11例眼压升高至21 mmHg以上,占14.1％. 结论 曲安奈德玻璃体腔注射联合黄斑格栅样光凝可有效治疗黄斑水肿,但少数患者在6个月内出现复发及眼压升高.     

玻璃体腔内注射曲安奈德治疗黄斑水肿的疗效探讨

目的:观察玻璃体腔注射曲安奈德治疗黄斑水肿的疗效。方法:对38例(40眼)黄斑水肿患者行玻璃体腔内注射曲安奈德后定期随访6mo,观察治疗前后视力、眼压及眼底FFA黄斑区改变情况。结果:全部患者玻璃体腔内注射曲安奈德后视力比术前提高,黄斑水肿消退或减轻。结论:玻璃体腔内注射曲安奈德可消除黄斑水肿,提高视力,但一过性高眼压及远期效果有待进一步研究     

玻璃体腔注射曲安奈德治疗视网膜静脉阻塞黄斑水肿

目的:评价玻璃体腔注射曲安奈德治疗视网膜静脉阻塞合并黄斑水肿的疗效及并发症。方法:患者30例30眼玻璃体腔注射曲安奈德4mg治疗视网膜静脉阻塞合并黄斑水肿,观察治疗前、后的最佳矫正视力、眼压、裂隙灯显微镜检查、眼底荧光血管造影和光学相干断层扫描的变化,采用SPSS 12.0软件进行统计学分析。结果:所有患者手术后视力均显著提高,平均黄斑中心凹厚度(CMT)显著减少。病程、年龄、注射前CMT及视网膜静脉阻塞的类型和视力预后无相关性,注射前视力与注射后末次视力呈正相关。结论:玻璃体腔注射曲安奈德治疗视网膜静脉阻塞合并黄斑水肿简单、安全、易操作,短期内可以迅速减轻黄斑水肿,最终的视力预后取决于治疗前的视力,部分患者在注射后3 ～6mo可能复发。     

药物辅助下玻璃体切除术治疗增生性糖尿病视网膜病变

目的:探讨曲安奈德联合Bevacizumab(Avastin)辅助玻璃体切除术治疗严重糖尿病视网膜病变的临床应用价值。方法:回顾性分析药物辅助下玻璃体切除治疗的严重增生性糖尿病视网膜病变13例15眼,15眼均于术前3~14d行Bevacizumab(Avastin)1.25mg/0.05mL玻璃体腔注射,常规玻璃体切除术中使用曲安奈德辅助切除残留的玻璃体皮质、视网膜增殖膜,其中9例合并牵拉性视网膜脱离及黄斑水肿者硅油填充并留置4mg/0.1mL曲安奈德,4眼未使用硅油填充眼因合并黄斑水肿大量硬性渗出予曲安奈德留置。2眼单纯玻璃体积血者未注射曲安奈德。结果:除1例玻璃体腔注射Avastin 3d后术中出血较多特别是在剥离纤维新生血管膜过程中,其余病例术中出血很少,并能迅速自凝。联合曲安奈德辅助可清晰地辨别残留皮质、视网膜前膜甚至内界膜,黄斑水肿术后明显减轻,所有病例术后炎症反应轻,眼压控制良好,硅油眼中留置曲安奈德无明显并发症。结论:严重的增生性糖尿病视网膜病变玻璃体切除术前7~14d玻璃体腔注射Bevacizumab(Avastin),明显减少术中出血,术中使用曲安奈德辅助可视性良好。术毕留置4mg曲安奈德可有效减轻黄斑水肿及术后反应。     

两种剂量的曲安奈德玻璃体腔注射联合激光治疗黄斑水肿的疗效比较

目的:不同剂量的曲安奈德玻璃体腔注射联合激光光凝术治疗黄斑水肿的疗效比较.方法:前瞻性研究,2014-07/2015-10就诊于我院的黄斑水肿患者,随机纳入2mg组和4mg组54例54眼,进行曲安奈德玻璃体腔注射,术后2wk～1mo进行视网膜激光光凝治疗,术后1、3、6mo随访患者视力、黄斑厚度、有无并发症等情况.结果:2mg组和4mg组患眼曲安奈德玻璃体腔注射联合激光光凝术后均可使患者视力提高,黄斑厚度变薄,与各自治疗前比较差异有显著统计学意义(P＜0.01);两组治疗前后不同时间点视力提高和黄斑厚度变薄程度相互比较,差异无统计学意义(P＞0.05);两组并发症发生率比较差异无统计学意义(P＞0.05).结论:2mg曲安奈德玻璃体腔注射联合激光光凝术治疗黄斑水肿,疗效与4mg剂量相当,临床可选择2mg剂量代替4mg.     

小剂量曲安奈德玻璃体腔内注射治疗黄斑水肿

目的评价小剂量曲安奈德玻璃体腔内注射治疗黄斑水肿的效果和安全性。方法31例(31眼)黄斑水肿患者,其中糖尿病性黄斑水肿19例、视网膜中央静脉阻塞性黄斑水肿8例、白内障术后黄斑水肿4例,所有患者均行6mg曲安奈德玻璃体腔内注射。在注射后1周、1个月、2个月、3个月对患者视力、眼压进行检查并行黄斑部光相干断层扫描检查黄斑区视网膜厚度和黄斑区视网膜总容积。结果所有患者的视力在注射后均有一定升高,经LogMAR转换后注射前和注射后3个月视力分别为0.620±0.334和0·455±0·313(P<0.05);黄斑区视网膜厚度和容积下降,注射后3个月分别为(312±146)μm和(2.61±0.27)mm3,与注射前相比[(484±216)μm和(3.76±0.56)mm3]差异有显著性意义(P<0.05)。随访1周、1个月、2个月时的平均眼压[(18.1±6.4)mmHg、(18.9±6.3)mmHg、(17.6±5.8)mmHg,1kPa=7.5mmHg]较注射前平均水平[(14.2±4.6)mmHg]显著升高(P<0.05)。随访期内1例患者因白内障进展而需手术治疗。结论至少3个月随访期内,小剂量曲安奈德玻璃体腔内注射治疗黄斑水肿安全有效,没有严重并发症。     

球后注射曲安奈德联合激光光凝治疗白内障术后慢性黄斑囊样水肿

目的:观察比较激光治疗与激光联合球后注射曲安奈德(triamcinolone acetonide,TA)治疗白内障术后慢性黄斑囊样水肿的临床疗效。方法:对37例37眼白内障术后发生慢性黄斑囊样水肿的患者17眼,球后注射曲安奈德联合激光光凝,20眼单纯光凝治疗,随访6mo,对比分析两组治疗前后视力、眼底荧光素血管造影的变化及并发症。结果:所有患者治疗1mo后视力多数有明显提高。治疗6mo后,联合治疗组视力提高>2行者11眼(65%),视力稳定及变化在1行之内者4眼(23%),视力下降>2行者2眼(12%);水肿减轻14眼(82%),水肿未退3眼(18%);单纯光凝组视力提高>2行者3眼(15%),视力稳定及变化在1行之内者11眼(55%),视力下降>2行者6眼(30%)。水肿减轻9眼(40%),水肿未退11眼(60%)。两组比较差异有统计学意义(P<0.05)。结论:激光联合球后注射曲安奈德较单纯激光治疗白内障术后黄斑囊样水肿疗效更好,且安全、方便。     

玻璃体腔注射曲安奈德治疗白内障术后黄斑囊样水肿疗效观察

目的:观察玻璃体腔注射曲安奈德(triamcinoloneacetonide,TA)治疗白内障术后黄斑囊样水肿(cystoid macular ede-ma,CME)的疗效。方法:对21例22眼经间接检眼镜、荧光素眼底血管造影(FFA)以及光学相干断层扫描(OCT)检查确诊的CME患者行TA玻璃体腔注射,治疗后随访0.5a,对比分析术前术后不同时期的视力、眼底、FFA表现,观察OCT显示黄斑水肿高度。结果:术前视力平均0.25±0.23,术后3mo平均0.58±0.27,差异有显著性(P<0.01);经OCT随访检查,术后所有病例患眼黄斑中心凹厚度均有下降,术前平均为(482.37±102.54)μm,术后3mo平均为(205.46±113.35)μm,差异有显著性(P<0.01)。结论:玻璃体腔注射TA是一种安全有效的治疗白内障术后黄斑囊样水肿的方法。     

玻璃体内注射雷珠单抗联合曲安奈德治疗Ⅱ型视盘血管炎继发黄斑水肿

目的 评价玻璃体内注射雷珠单抗(ranibizumab)联合曲安奈德(triamcinolone acetonide,TA)治疗Ⅱ型视盘血管炎继发黄斑水肿的临床疗效和安全性.方法 选取2013年1月至2015年12月Ⅱ型视盘血管炎继发黄斑水肿患者19例(19眼),所有患眼均行雷珠单抗玻璃体内注射,2周后行TA玻璃体内注射.术后随访6个月,观察视力、眼压、眼底表现、三维光学相干断层扫描、眼底荧光血管造影及相关并发症.随访期间若黄斑水肿复发则再次行雷珠单抗联合TA治疗,直至黄斑水肿消退.结果 治疗前患眼视力为0.16±0.09,黄斑中心凹视网膜厚度为(694.88 ±79.06) μm.治疗后1个月、3个月、6个月分别与治疗前相比,视力显著提高,黄斑中心凹视网膜厚度显著降低,差异均有统计学意义(均为P ＜0.05);治疗后3个月、6个月分别与治疗后1个月相比,视力及黄斑中心凹视网膜厚度无显著变化,差异均无统计学意义(均为P ＞0.05).除1眼在首次玻璃体内注射雷珠单抗后出现一过性眼压升高外,其余患眼随访期间眼压均在正常范围.治疗后1个月眼底荧光血管造影检查示视网膜出血、渗出明显吸收,视盘及黄斑部荧光素渗漏明显减轻.患眼平均注药次数为2.11次.随访期间均未观察到与玻璃体内注射及药物相关的并发症.结论雷珠单抗联合TA治疗Ⅱ型视盘血管炎继发性黄斑水肿具有良好的疗效及安全性,可以明显缩短治疗周期、减少药物注射次数,手术创伤小、并发症少.     

玻璃体内注射酮咯酸治疗白内障术后慢性黄斑囊样水肿

目的：探讨玻璃体内注射酮咯酸治疗白内障术后慢性黄斑囊样水肿的临床疗效。方法：选取2014-03/2016-02我院收治的白内障手术后并发黄斑囊样水肿患者38例,行玻璃体内注射酮咯酸治疗。治疗后,采用荧光素血管造影术( FFA)和光学相干断层扫描( OCT)进行临床检查,观察临床疗效,对比分析治疗前及治疗后2、4wk,3、6mo患者的矫正视力变化、眼压、黄斑区中心视网膜厚度。结果：与治疗前相比,玻璃体内注射酮咯酸治疗后FFA显示患者渗漏显著地减低,患者黄斑区水肿消退,同时,矫正视力显著提高,差异有统计学意义(P<0.05),眼压显著改善,差异有统计学意义(P<0.05),黄斑区平均厚度显著减少,差异有统计学意义(P<0.05)。结论：玻璃体内注射酮咯酸治疗白内障术后慢性黄斑囊样水肿有良好的治疗效果。     

Intravitreal triamcinolone for refractory pseudophakic macular edema

PURPOSE: To evaluate the efficacy of intravitreal triamcinolone in refractory pseudophakic cystoid macular edema. DESIGN: A prospective, interventional case series. METHODS: Three eyes of three patients with longstanding pseudophakic cystoid macular edema following uncomplicated cataract surgery, refractory to any medication, were treated with 8 mg of intravitreal triamcinolone. All three eyes were evaluated before injection and throughout follow-up with the Early Treatment Diabetic Retinopathy Study's visual acuity chart, fluorescein angiography, and macular mapping using optical coherence tomography. RESULTS: A month after intravitreal triamcinolone injection, a dramatic decrease in macular thickness was noted by optical coherence tomography in all three eyes (from a mean of 502-233 microm). Mean improvement in visual acuity was 3.7 Snellen lines. Two to 4 months after triamcinolone injection, however, the edema recurred in all cases, to the same degree as before the injection, combined with a decrease in vision. Two eyes underwent a second injection of triamcinolone, and macular thickness decreased, but the edema again recurred 3 months after injection. CONCLUSION: Intravitreal injection of triamcinolone induces striking regression, within 1 month, of chronic refractory macular edema. This regression appears to be transient, however, even after a second injection.     

Intravitreal injection of triamcinolone acetonide for cystoid macular edema resistant to vitreous surgery

PURPOSE: To report the efficacy of intravitreal injection of triamcinolone acetonide(TA) for cystoid macular edema remaining after vitreous surgery. METHODS: Eight eyes of 7 patients aged from 32 to 84 years old were studied. The original diseases that caused macular edema were central retinal vein occlusion in 2 eyes, branch retinal vein occlusion in one eye, Irvine-Gass syndrome in 2 eyes, and diabetic retinopathy in 3 eyes. 4 mg of TA was injected intravitreally and visual acuity and foveal thickness measured by optical coherence tomography(OCT) were evaluated in before and after the surgery. RESULTS: Macular edema resolved rapidly after injection of TA in all cases and cysts were extinguished or diminished. The foveal thickness in OCT was reduced significantly from preoperative 495 +/- 116 (mean +/- standard deviation) microns to 267 +/- 117 microns after one week, and 246 +/- 81 microns after one month. The effect persisted for three months. Visual improvement of more than two Snellen lines was seen in 4 eyes. No side effects were observed except a temporary increase of intraocular pressure in one eye. CONCLUSION: Intravitreal injection of TA is effective in a short-term for cystoid macular edema remaining after vitrectomy.     

Intravitreal triamcinolone acetonide for pseudophakic cystoid macular edema

PURPOSE: To report the clinical outcome of patients undergoing intravitreal injection of triamcinolone acetonide as treatment of long-standing cystoid macular edema after phacoemulsification. DESIGN: Prospective clinical interventional cases series studies. METHODS: The study included five patients suffering from cystoid macular edema after cataract surgery. They received an intravitreal injection of 25-mg crystalline triamcinolone acetonide transconjunctivally with topical anesthesia. RESULTS: In the follow-up period of 6.6 +/- 4.1 months, visual acuity increased from 0.26 +/- 0.13 to a mean maximal visual acuity of 0.60 +/- 0.19. For all patients, visual acuity improved during the follow-up by at least 0.20. Two (40%) patients developed intraocular pressure values higher than 21 mm Hg, which could be controlled by topical antiglaucomatous treatment. CONCLUSIONS: Intravitreal triamcinolone acetonide may be a therapeutic option for long-standing cystoid macular edema after cataract surgery.     

Intravitreal triamcinolone for uveitic cystoid macular edema: an optical coherence tomography study

PURPOSE: To investigate the use of intravitreal injection of triamcinolone acetonide (TA) for the treatment of refractory uveitic cystoid macular edema (CME). DESIGN: Prospective, nonrandomized, self-controlled comparative trial. PARTICIPANTS: Six patients with chronic CME resistant to treatment with systemic steroids, orbital floor steroids, and cyclosporine A. Three patients were followed for more than 1 year, and the other three for between 3 and 9 months. INTERVENTION: Injection of 2 mg of TA into the vitreous cavity. TESTING: Optical coherence tomography scanning of the fovea before and after injection and logarithmic minimal angle of resolution visual acuity. MAIN OUTCOME MEASURES: Visual acuity, retinal thickness, cystoid space height, and intraocular pressure. RESULTS: There was complete anatomic resolution of CME in five of the six cases within 1 week after injection. Cystoid spaces began to return between 6 weeks and 3 months after injection. Two patients with longer term follow-up responded to further orbital floor steroid injection and had no CME 1 year later. One patient had raised intraocular pressure develop, requiring a trabeculectomy. Mean improvement in visual acuity after 12 months was 0.27 (range, 0.14-0.42). CONCLUSIONS: Complete anatomic and, to some extent, functional recovery can be induced by intravitreal TA despite long-term refractory inflammatory CME. Optical coherence tomography aids in the management of these cases.     

TA联合激光治疗视网膜静脉阻塞黄斑水肿的临床观察

目的:观察玻璃体腔内注射曲安奈德联合激光光凝治疗视网膜静脉阻塞引起的黄斑水肿的有效性和安全性。方法:患者38例38眼经眼底镜检查、眼底荧光素血管造影(fundus fluorescein angiography,FFA)及光学相干断层扫描(optical coherence tomography,OCT)检查明确诊断的视网膜静脉阻塞引起的黄斑水肿,玻璃体腔内注入曲安奈德4mg(0.1mL),术后1～2mo时行视网膜激光光凝,随访3～9mo,观察视力、眼压、眼底情况及视网膜厚度变化。结果:视力提高36眼,视力无变化2眼。视力<0.1者3眼,0.1～0.3者11眼,0.3～0.5者17眼,>0.5者7眼。4例患者眼压不同程度升高,予以局部降眼压药物治疗后,术后2～5mo眼压恢复正常,未发生1例视网膜毒性反应。结论:曲安奈德联合激光可以安全、有效治疗视网膜静脉阻塞引起的黄斑水肿,提高患者视功能。     

Intravitreal triamcinolone acetonide for persisting cystoid macular edema after penetrating keratoplasty

PURPOSE: The intravitreal application of triamcinolone acetonide as treatment of long-standing, therapy-resistant cystoid macular edema after penetrating keratoplasty is reported. METHODS: A 44-year-old patient showed therapy-resistant cystoid macular edema for 2 years after repeated penetrating keratoplasty was performed as treatment of keratoconus. The crystalline lens was clear. The patient received an intravitreal injection of approximately 20 mg of triamcinolone acetonide. Preinjection visual acuity measured 20/80. RESULTS: Within the first 4 weeks after the injection, dense cataract developed necessitating cataract surgery. After phakoemulsification, visual acuity improved to 20/50. Optical coherent tomography and fluorescein angiography showed an almost complete resolution of cystoid macular edema. Ten months after the injection, visual acuity remained at 20/50, and intraocular pressure measured 15 mm Hg without antiglaucomatous therapy taken. CONCLUSIONS: Intravitreal injection of triamcinolone acetonide may be an additional tool in the treatment of therapy-resistant cystoid macular edema after penetrating keratoplasty. After intravitreal injection of triamcinolone acetonide, cataract may rapidly develop in eyes that have been intensively treated, topically and systemically, by corticosteroids for several years.