Triamcinolone is a longer-acting steroid that is very useful for intra-ocular surgery. We can use it to modulate inflammation, to stain prolapsed vitreous, to verify fluidic outflow for glaucoma devices, and to treat macular edema. In my surgeries, we use the preservative-free version of triamcinolone which costs $100 or more per dose. The generic version has some preservatives but is far cheaper at about $6 per vial (both being 1 ml at a concentration of 40 mg/ml) and it may be even less in other countries. Years ago, the preservative-free version was not available in the USA, so we resorted to washing the triamcinolone (brand name Kenalog) particles with this method:
Since then, we have found that an even easier method is to simply aspirate the majority of the liquid from the unshaken vial of triamcinolone and then replace it with balanced salt solution (BSS). This removes about 90% of the preservatives.
Off-label use: note that in the USA, these methods of preparing triamcinolone may be considered off-label and no claims or recommendations are being made regarding this use. This is for your educational benefit only and the surgeons should use their own judgment for their patients.
click to learn how to prepare triamcinolone for intra-ocular use:
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