Abstract
Purpose :
Intracameral triamcinolone (TA) is used at the time of uveitic cataract surgery to reduce postoperative inflammatory complications. However, there are currently no studies specifically investigating its use in this setting. We performed a retrospective study to evaluate the safety and efficacy of intracameral TA in reducing postoperative inflammation in uveitic cataract surgery.
Methods :
A retrospective cohort study from 2005 to 2020 was conducted by reviewing medical records with a postoperative follow-up period of at least one month, through to 12 months. Consecutive adult patients with uveitis requiring cataract surgery with significant iris manipulation (use of iris hooks or a Malyugin Ring), were included in the study. Cases prior to 2009 where intracameral TA was not used (control group) were compared with cases after 2009 where intracameral TA was administered (study group).
Results :
54 eyes from 46 patients were included in the study group and 19 eyes from 16 patients were included in the control group with a mean follow up of 8.2 months and 9.2 months respectively. Significantly fewer eyes in the study group developed cystic macular edema (CME) during follow-up (22% vs 53%, RR 0.42 (95% CI 0.22 to 0.83), p=0.020). At one month, eyes that received intracameral TA had only ¼ the risk of having CME compared to the control group (9% vs 35%, RR 0.26, (95% CI 0.10 to 0.75), p=0.019). Visual acuity (VA) was not significantly different between the two groups at baseline (p= 0.06), with the study group achieving a better median VA than the control group at one (p=0.013) and three months (p=0.009) postoperatively (Figure 1). Mean intraocular pressure (IOP) was lower in the study group at one week (p=0.004) and three months postoperatively (p=0.015). In the study group there were more cases of IOP-rise ≥10mmHg (50% vs 37%, p=0.425) and ≥ 20mmHg (36% vs 11%, p=0.210). There were low rates of other adverse events. Patterns of inflammation control were not significantly different at any time point.
Conclusions :
Our findings support the use of intracameral TA as a safe and effective method of reducing postoperative inflammation for uveitic cataract surgery. It appears to be particularly effective for prevention of early CME which may confer a visual acuity benefit.
This is a 2021 ARVO Annual Meeting abstract.