Abstract
Purpose: To evaluate the safety and efficacy of a single intracameral injection of triamcinolone acetonide in controlling postoperative ocular inflammation and improving the outcome of pediatric cataract surgery with intraocular lens implantation. Setting: Prospective interventional comparative Quasi study. Patients and methods: The study was performed on eyes of children between 6-12 years old having significant cataract and subjected to cataract extraction with primary IOL implantation. Patients were divided into two almost equal age and sex matched groups. The study group included eyes that received intracameral injection of 4 mg/0.13 ml of preservative-free triamcinolone acetonide at the end of surgery while the control group included eyes that did not receive intracameral injection of triamcinolone acetonide. Postoperative examinations were done on day 1 then weekly for 1 month, and monthly for another 2 months. Primary outcome measures included any sign of anterior segment inflammation, while secondary outcome measures included best corrected visual acuity, intraocular pressure and any reported complication caused by intracameral triamcinolone acetonide. Results: The study included 42 eyes (35 patients); 21 eyes in each group. Postoperative inflammatory membrane was statistically significant higher in the control group than in the study group (P=0.018). The mean duration of using topical steroids in the study group (17.2 ± 4.1 days) was statistically significant less than its mean duration (28.3 ± 3.4 days) in the control group (P<0.05). No statistically significant differences were detected between pre and postoperative intraocular pressure in each group and in between both groups. No significant complications related to intracameral triamcinolone acetonide were reported. Conclusion: A single intracameral injection of 4 mg preservative free triamcinolone acetonide at the end of uncomplicated pediatric cataract surgery could be an effective and safe adjunct to postoperative topical steroids in controlling postoperative ocular inflammation.
Highlights
Pediatric cataract surgery is followed by a high incidence of postoperative inflammation of varying severities in almost all patients
Non-compliance and missed doses interfere with proper control of postoperative uveitis [1]
Postoperative severe inflammatory reaction can lead to poor visual outcome and long term morbidity
Summary
Pediatric cataract surgery is followed by a high incidence of postoperative inflammation of varying severities in almost all patients. Intensive topical steroid therapy is still the mainstay for prevention and treatment of postoperative inflammation. Adjuvant systemic steroids may be needed for further control. Topical and oral steroids require frequent doses and strict compliance. Non-compliance and missed doses interfere with proper control of postoperative uveitis [1]. Subconjunctival or sub-Tenon’s steroid injection is sometimes needed which means repeated exposure to general anesthesia
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