Corticosteroids were the first agents to be employed in the treatment of experimental PVR and have recently regained currency based upon their widely disparate effects . It is known that steroids exhibit a bimodal effect on cultured fibroblasts, causing stimulation at low doses and inhibition at supraphysiological doses . Triam-cinolone acetonide has been shown to reduce experimental PVR in a rabbit model after the injection of cultured fibroblasts . One human clinical study employing oral prednisone showed a reduced rate of macular pucker, a limited form of proliferative response, after retinal reattachment surgery, although it did not affect the ultimate reattachment rate or rate of PVR . Intravitreal steroids, when included in the infusate with heparin, resulted in a lower rate of retinal reoperation in one clinical study . A novel use of intra-vitreal triamcinolone recently described by Peyman and colleagues involves visualizing remnants of the residual vitreous cortex following injection of a suspension of triamcinolone acetonide and, thereby, enhancing a full removal of cortex and vitreous membranes in a more expeditious manner .
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