Intracameral Injection of Triamcinolone Acetonide During Cataract Surgery in Eyes With Uveitis
Purpose
To evaluate the efficacy and safety on the use of preservative containing intracameral triamcinolone acetonide (ICTA) during cataract surgery, in patients with visually significant cataract and history of uveitis.
Methods
Prospective interventional case series. 9 eyes of 9 patients with previous uveitis, underwent cataract surgery with 0.01 ml ICTA (Kenalog, 4 mg/0.1 mL) injected at the end of cataract surgery. None of the patients received topical steroids in the post operative period. All eyes were free of intraocular inflammation for at least six months prior to cataract surgery. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, and intraocular pressure (IOP) were evaluated pre and post operatively. All patients had pre operative and post operative endothelial cell count measurements, with an average follow- up time of 19.2 months.
Results
There were no intraopertative complications. Mean age of the cohort was 68 ± 11 years (range 50-82years). Mean improvement in UDVA was 0.62 logMAR. Pre operative mean endothelial cell count was 2300 ± 458 cells/mm2. At a mean follow up of 19.2 ± 13.7 months, mean endothelial cell loss was 8.6%. No intraocular pressure spikes were noted up to 6 months post operatively in our study group. One patient developed cystoid macular oedema postoperatively, and two patients had a recurrence of uveitis within 6 months following cataract surgery.
Conclusion
Preservative containing 0.01ml intracameral triamcinolone acetonide (Kenalog, 4 mg/0.1 mL) can be used safely and effectively as an intracameral agent, without detriment to endothelial cell count during cataract surgery in uveitic eyes.