Objective: To evaluate the results of intravitreal triamcinolone acetonide injection (IVTA) by treatment of laser photocoagulation in the patients with refractory diabetic macular edema (DMO).

Materials and Methods: 145 eyes of 98 patients with diffuse diabetic macular edema were included into the study. 0.1 ml / 4 mg of triamcinolone acetonide was injected intravitreally under topical anesthesia. Best-corrected visual acuity (BCVA) and intraocular pressure (IOP) was measured. Optical coherence tomography (OCT) and fluorescein angiography (FA) results were evaluated before and after injection. The patients were followed up at first day, third and sixth months after the injections.

Results: The mean age of patients was 59.60±12.6 (35-85 years), mean follow-up period was 14.60±4:51 months (6-48 months). All of the patients underwent the laser treatment at first, but macular edema was resistant. 77 (53.10%) eyes showed an increase in visual acuity at first month after the injection. 44 (30.34%) eyes had got no change in visual acuity. 24 (16.55%) eyes had decreases in visual acuity. Visual acuity was 0.20±0.18 pre-injection and BCVA was 0.20±0.16 at the first day, 0.26±0.20 at the first month, 0.28±0.20 at the third month and 0.20±0.25 at the sixth month after injections. The mean IOP was 14.64±2.40 mmHg before injection and 30 (20.68%) eyes showed increase in intraocular pressure at the first month. Three (2.68%) eyes were treated with single antiglaucomatous therapy and 20 (13.79%) eyes were treated with combined therapy. By one eye (0.68%), retinal detachment due to retinal tear was observed. Eight eyes (5.5%) were in operation for cataract surgery.

Conclusion: Intravitreal injection of diabetic macular edema, provides anatomical recovery and improvement in visual acuity in the majority of patients which can be detected by OCT in the early period. Although Intravitreal injection may cause IOP elevation and cataract formation, as the most important complications, intravitreal laser treatment is a method which could be used in the treatment of refractory DME