Outcomes of cataract surgery and intraocular lens implantation with and without intracameral triamcinolone in pediatric eyes

Abstract

To evaluate whether intracameral triamcinolone has an effect on anterior segment inflammation and visual axis obscuration after pediatric cataract surgery with intraocular (IOL) implantation. Iladevi Cataract and IOL Research Institute, Ahmedabad, India. This retrospective age-matched case-control study comprised consecutive eyes of children having phacoaspiration, posterior capsulectomy, vitrectomy, and IOL implantation. In the study group, eyes received a standardized application of an intracameral preservative-free triamcinolone acetonide suspension intraoperatively. In the control group, age-matched consecutive eyes had surgery with a similar technique but without intracameral preservative-free triamcinolone acetonide. Cell deposits, posterior synechias, visual axis obscuration, and intraocular pressure (IOP) were evaluated 1 month and 12 months postoperatively. The mean patient age at surgery was 9.15 months +/- 5.04 (SD) in the study group (41 eyes) and 9.34 +/- 5.10 months in the control group (83 eyes) (P = .91). The visual axis was not obscured in any eye in the study group, while 9 eyes (10.8%) in the control group had an obscured axis; the difference between groups was statistically significant (P<.029). Six eyes (7.2%) in the control group required secondary membranectomy with pars plana vitrectomy. There was a statistically significant difference between the 2 groups in posterior synechias and cell deposits (both P<.033) and no significant difference in preoperative or postoperative IOP (P = .29 and P = .50, respectively). Pediatric eyes receiving intracameral triamcinolone intraoperatively had significantly less anterior segment inflammation and no visual axis obscuration after cataract surgery with IOL implantation.