Efficacy and safety of intracameral triamcinolone acetonide in uveitic cataract surgery

Michael R. Dong, Rod O'Day, Anthony J. Hall, Lyndell L. Lim

Meeting:  2022 RANZCO


Date:      -

Session Title: UVEITIS

Session Time:      -

Purpose: To evaluate the safety and efficacy of intracameral triamcinolone acetonide (TA) in reducing post-operative inflammation in uveitic cataract surgery.

Methods: Retrospective cohort study using medical records with a post-operative follow-up of at least one month, up to 12 months. Consecutive adult patients under- going uveitic cataract surgery with significant iris manipu- lation (iris hooks or Malyugin Ring), were included. Cases before 2009 where intracameral TA was not available (con- trol group) were compared with cases after 2009 where intracameral TA was administered (study group).

Results: Ffity-four eyes from 46 patients were in the study group, 19 eyes from 16 patients were in the control group. Significantly fewer eyes in the study group developed cystoid macular oedema (CMO) (22% vs 53%, RR
0.42 (95% confidence interval 0.22 to 0.83), p = 0.020). At one month, the study group had 1/4 the risk of having CMO compared to controls (9% vs 35%, RR 0.26, (95% confidence interval 0.10 to 0.75), p = 0.019). Visual acuity was not significantly different at baseline. The study group achieved a better median visual acuity than the control group at one (p = 0.013) and three months (p = 0.009). Mean intraocular pressure was lower in the study group at one week (p = 0.004) and three months post-operatively (p = 0.015). The study group had more cases of intraocular pressure-rise ≥10 mmHg (50% vs 37%, p = 0.425) and ≥ 20 mmHg (36% vs 11%, p = 0.210).

Conclusion: Our findings support using intracameral TA in uveitic cataract surgery to prevent post-operative inflammation. It appears to be effective for prevention of early CMO which may confer a visual acuity benefit.