June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Intracameral triamcinolone to reduce postoperative inflammation in uveitic cataract surgery
Author Affiliations & Notes
  • Michael Dong
    Central Clinical School, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Victoria, Australia
  • Rod O'Day
    Ophthalmology, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
  • Anthony John Hall
    Ophthalmology, Alfred Health, Melbourne, Victoria, Australia
    Central Clinical School, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Victoria, Australia
  • Lyndell L Lim
    Ophthalmology, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
    Clinical Trials Research Unit, Centre for Eye Research Australia Ltd, East Melbourne, Victoria, Australia
  • Footnotes
    Commercial Relationships   Michael Dong, None; Rod O'Day, None; Anthony Hall, None; Lyndell Lim, Allergan (F), Allergan (C), Bayer (F), Novartis R (R), Novotech (C)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 1402. doi:
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    • Get Citation

      Michael Dong, Rod O'Day, Anthony John Hall, Lyndell L Lim; Intracameral triamcinolone to reduce postoperative inflammation in uveitic cataract surgery. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1402.

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      © ARVO (1962-2015); The Authors (2016-present)

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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.

 

Figure 1. Median visual acuity from pre-operative to 12 months postoperative.

Figure 1. Median visual acuity from pre-operative to 12 months postoperative.

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