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To evaluate the efficacy of radial optic neurotomy (RON) with or without intravitreal triamcinolone in improving visual acuity in central retinal vein occlusion (CRVO). Materials and Methods: We performed vitrectomy and RON to 16 eyes of 16 patients with CRVO with a best corrected visual acuity (BCVA) of 20/200 or less. Eight of them received an injection of 4mg intravitreal triamcinolone (IVTA) at the completion of the surgery. The major outcome parameter was defined as an improvement of BCVA of 2 or more lines and final BCVA better than 20/200. Decrease in central macular thickness was our secondary outcome parameter. Intraoperative and postoperative complications were also evaluated. Results: Eleven (68.8%) of the eyes were evaluated as ischemic based on fluorescein angiography and presence of relative afferent pupillary defect. Only 2 (12.5%) patients had BCVA of better than 20/200 postoperatively. Central macular thickness was significantly reduced from 811±303 μ to 444±276 μ (p<0.01). Preoperative visual acuity and age were significant factors in affecting final BCVA of better than 20/200 (p=0.02 and p=0.05, respectively). One patient underwent trabeculectomy because of intractable open angle glaucoma. One additional patient developed neovascular glaucoma and was treated with diod laser cyclophotocoagulation. Conclusions: RON surgery with or without peroperative IVTA led to a significant decrease in central macular thickness but its functional success is very limited in eyes with preoperative BCVA of less than 20/200 and probably is not better than the natural history. [ABSTRACT FROM AUTHOR]