DESIGN: An interventional case series.

METHODS: Retrospective study. The setting was a tertiary care referral institute. Nine patients with central retinal vein occlusion and cystoid macular edema received 4.0 mg/0.1 ml of intravitreal triamcinolone acetate injected through the inferior pars plana under topical anesthesia. Baseline intraocular pressures were normal in all, and no patients had glaucoma.

RESULTS: Seven of the nine patients had a post,injection rise in intraocular pressures, of which one had intractable secondary glaucoma requiring removal of the depot corticosteroid by pars plana vitrectomy combined with tra-beculectomy. Two patients were controlled only by maximal medical therapy.

CONCLUSIONS: The occurrence of intractable glaucoma after intravitreal triamcinolone in central retinal vein occlusion is a serious concern and warrants caution in the use of this modality for these patients. (C) 2004 by Elsevier Inc. All rights reserved.