No Topical Steroids After Phacoemulsification: High on Compliance

Monday, April 20, 2015: 3:26 PM
Room 1B (San Diego Convention Center)
Debashis Dutta, MS
Saswata Biswas, DO

Use of intracameral triamcinolone after uncomplicated cataract surgery to improves patient comfort and convenience. Topical steroids are barely necessary.

It is a prospective randomized masked study. Only normal eyes with senile cataracts up to grade 3 were enrolled for study. 5423 eyes of 5022 patients undergoing phaco were randomized into 2 groups. After surgery, eyes in group A received 2mg/0.1 ml TA in anterior chamber. Group B received topical prednisolone acetate 1% drops in tapering doses. Topical steroids were not used at all in group A. To evaluate the efficacy of intracameral Triamcinolone acetonide, cells, flare and cilliary injection were noted on postop days 1, 10, 30, and 90 by slitlamp. The safety and efficacy of intracameral TA was evaluated by visual acuity, IOP values. Patient comfort was assessed by a questionnaire.

Both treatments were equally effective in controlling postoperative inflammation following phacoemulsification. No statistically significant differences (p ≥ 0.05) between groups were observed for the efficacy, safety and tolerance variables, and no serious adverse events were observed. There were no statistically significant (p ≥ 0.05) differences in mean V A and the amount of anterior chamber cells and flare between the 2 groups at any postoperative visit. 3.2% patients experienced increase of IOP which was controlled in all cases by 0.5% timolol maleate.

Intracameral Triamcinolone of 2 mg can effectively be used to control postoperative inflammation after uncomplicated phaco. The dosage and duration of topical steroids is reduced. No tear film disruption and patient is happy. The anterior chamber is cloudy immediately after operation and takes a couple of hours to clear.