Abstract
IntroductionStudies have shown that repeated peribulbar triamcinolone injections reduce the inflammatory signs of moderate to severe thyroid eye disease (TED). Other studies found that TED was associated with greater with-the-rule corneal astigmatism owing to fibrosis of the soft tissue in the superolateral orbital region. This study aimed to detect the effect of repeated peribulbar triamcinolone injections in patients with moderate to severe TED on corneal topography and astigmatism.Patients and methodsA prospective, controlled, and randomized study was conducted that included 30 eyes with moderate to severe TED who underwent repeated peribulbar triamcinolone injections in addition to pretreatment and posttreatment corneal topography using Occulus Pentacam. The patients received repeated peribulbar injections of 20-mg triamcinolone acetate (40 mg/ml) for four doses with a 1-week interval.ResultsOn a comparison between pretreatment and posttreatment corneal topographic measures, it revealed a highly statistically significant difference between pretreatment and posttreatment results according to K-max and Pentacam astigmatism. In contrast, the Pentacam astigmatism axis and central corneal thickness by Pentacam show a statistically insignificant difference between preinjection and postinjection periods. A comparison between the mean difference of pretreatment and posttreatment refraction showed a statistically significant difference between both according to mean differences of the cylinder.ConclusionA significant change in corneal curvature occurs after repeated peribulbar injection of triamcinolone acetate in patients with TED. The amount of this change in corneal curvature is sufficient to change the posttreatment refraction of the eye.
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