Journal
RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES
Volume 29, Issue 5, Pages 689-698Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/IAE.0b013e31819e390a
Keywords
triamcinolone acetonide; kenalog; triesence; trivaris; intravitreal injection
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Funding
- Palin Beach Community Trust Fund
- pharmaceutical industry
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Purpose: To characterize the in vitro behavior of three preparations of triamcinolone acetonide (TA). Methods: Three preparations of TA were mixed with Balanced Salt Solution Plus: commercially available TA (Kenalog 40, Bristol-Myers Squibb, Princeton, NJ), compounded preservative-free triamcinolone acetonide (PFTA, New England Compounding Center, Framingham, MA), and triamcinolone acetonide injectable suspension (TAIS, TRIESENCE, Alcon, Inc., Fort Worth, TX). We determined the mean number of crystalline aggregates per high-power deconvolution microscopy field, largest aggregate area, and spectroscopic photometric absorption. Results: Preservative-free triamcinolone acetonide had larger mean number of aggregates compared with TA (time 0 P = 0.002, 10 minutes P < 0.001) and TAIS (time 0 P < 0.001, 10 minutes P = 0.003). Aggregate size varied at both 0 and 10 minutes: TAIS > TA > PFTA. Spectroscopic photometric absorption decreased in direct correlation to aggregate size over time for all three preparations. Conclusion: In vitro, PFTA in Balanced Salt Solution Plus had more aggregates of smaller size than either TA or TAIS. By contrast, TAIS had much larger aggregate size than both PFTA and TA, and this increased overtime. These findings correlate with the clinical observations that PFTA and TA tend to disperse throughout the vitreous, whereas TAIS tends to conglomerate and gravitate toward the most dependent portion of the eye in a globular fashion. RETINA 29:689-698, 2009
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