The Effect of Intravitreal Kenolog on Intraocular Pressure in Patients with Glaucoma

Abstract

Purpose: Intravitreal triamcinolone acetonide (Kenolog) injections are used to treat a broad spectrum of retinal diseases causing macular edema. The purpose of this study was to determine the effect of intravitreal kenolog injection on intraocular pressure (IOP) in patients with glaucoma, glaucoma suspect or without glaucoma.

Methods: Retrospective chart review of Kresge Eye Institute patients that had received intravitreous kenolog injection. Patients were subdivided into three groups: patients with diagnosis of glaucoma, glaucoma suspect, and patients without glaucoma. Each group was assessed for IOP measurements prior to injection. Subsequent measurements were taken at 1-2, 3-5, and 6-9 months post injection.

Results: Data was collected from 81 patients who had kenolog injections between 2006 and 2012. There were 52 females and 29 males. Average patient age was 60 years. There were 60 (74%) patients without glaucoma, 11 (14%) with glaucoma and 10 (12%) glaucoma suspects. One to two months post injection, IOP increased in 60.3% of the non-glaucoma group (0.87± 5.95 mmHg), 38.5% of the Glaucoma group (1.23±9.30) and 57.1% of the Glaucoma Suspect group (1.14±4.10). Within this time period there was one occurrence of acute angle closure requiring surgical intervention in the glaucoma group. Three to five months post injection IOP remained elevated in 44% of the non-glaucoma group (-0.31±4.60), 50% of Glaucoma group (6.29±12.61), and 60% of Glaucoma Suspect (2.2±4.21). Lastly, at six to nine months the IOP remained elevated in 59.1% of non-glaucoma (1.8±6.24), 25% Glaucoma (-3.38±4.57) and 60% of Glaucoma suspect (1.8±4.32). There was no statistically significant difference in IOP change among groups. In addition, there was no significant difference between the pre-injection and post-injection IOP in any of the groups.

Conclusions: Although there were incidences of elevation in IOP post injection in all three groups, upon comparison there was no significant difference among the glaucoma, glaucoma suspect or non-glaucoma patients.

Keywords: 561 injection • 568 intraocular pressure