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Preparing Highly Concentrated Triamcinolone

To prepare highly concentrated triamcinolone (HCT), an entire 40-mg vial of triamcinolone (Kenalog-40, Bristol-Myers Squibb) is aspirated into a 1-cc syringe, the needle is replaced with a sterile cap, and the plunger and flanges of the syringe are removed. The syringe is then placed in a centrifuge. After 30 seconds at the highest speed, the syringe is rotated 180° and centrifuged for another 30 seconds. The supernatant is discarded, and the remaining pellet of triamcinolone is prepared for intravitreal injection using the existing syringe.

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