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D. Yin, A. Ali, M. C. Samson; Intravitreal Injection of Kenalog as an Adjunctive Treatment for Uveitis Patient Undergoing Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2009;50(13):6048.
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To evaluate the clinical outcome of intravitreal injection of kenalog as an adjunctive treatment for uveitis patients undergoing cataract surgery compare to cataract surgery without kenalog injection. Post operative best corrected visual acuity (BCVA), inflammation, IOP fluctuation, posterior capsule opacification (PCO) and complication of cystoid macular edema (CME) are assessed.
The charts of 53 uveitis patients (56 eyes) who underwent cataract surgery were reviewed. We found a study group of 14 patients (15 eyes) that received 20mg of intravitreal injection and a control group of 39 patients (41 eyes) that did not receive intravitreal injection. The data were collected retrospectively for 4 months preoperatively and 6 months postoperatively. Analysis of the data was conducted by SAS statistic software.
In the intravitreal injection reviewed group, 57.2% patients improved more than 6-9 lines in BCVA after the cataract surgery comparing to 34.4% in the controlled group during postoperation follow-up. Improvement of BCVA (p<0.05) is greater in the study group compare to the control group. Patients with anterior uveitis and panuveitis responded to kenalog treatment better than intermediate and posterior uveitis. Statistically significant differences of BCVA improvement were seen postoperatively in anterior uveitis (p=0.0002) and in panuveitis (p=0.0022), but not in intermediate and posterior uveitis. In both the control and study groups, IOP was relatively stable postoperatively. In terms of posterior capsule opacification, 33% of the study group developed PCO compare to 27% in the control group. However, only 20% of the study group with PCO required Nd:YAG treatment compare to 64% in the control group that developed PCO. Moreover, patients that received kenalog treatment had higher AC cells pre-operatively as expected. However, by post operation month 3, the inflammation in the study group was lowered than the controlled group. As for postoperative complication, only 10% of the study group developed cystoid macular edema compare to 20% in the control group. No other complication emerged during the 6 months follow-up period.
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