Comparison of topical steroids versus adjunctive intracameral triamcinolone versus posterior subtenon triamcinolone in pediatric cataract surgery

Purpose: Prolonged postoperative topical corticosteroids are commonly given after pediatric cataract surgery to control inflammation. This study was undertaken to compare the efficacy, safety, and compliance of postoperative topical steroids and adjunctive intracameral (I/C) triamcinolone acetonide (tricort) and posterior subtenon (PST) triamcinolone in modulating postoperative inflammation after surgery. Methods: Forty?eight eyes of children with pediatric cataract between the ages of 5 and 10 years were randomized into three equal groups (T, I, S) before surgery. Group T received postoperative topical 1% prednisolone tapered over 4 weeks; Group I received adjunctive intraoperative I/C 1.2 mg/0.03 ml tricort and topical 1% prednisolone for 2 weeks postoperatively, and Group S received a single 0.5 ml (40 mg/ ml) PST tricort without topical steroids. Signs of inflammation, intraocular pressure (IOP), and central corneal thickness were assessed at day 1, week 1, week 3, week 6, and week 12 postoperatively with optical coherence tomography (OCT) macula to rule out cystoid macular edema at the sixth and 12th weeks postoperatively. Results: Posterior synechiae were present in two eyes out of 16 in groups T and I, which resolved. Severe anterior chamber cells were present in four eyes out of 16 in group T, in two eyes in group I, and in one eye in group S, which resolved. All groups had comparable pre? and postoperative IOP. Conclusion: In pediatric cataracts, outcomes were better with PST tricort and the adjunctive I/C tricort compared to postoperative topical prednisolone, for modulating postoperative inflammation

Effect of Intracameral Triamcinolone to Control Inflammation in Rabbit Eyes

PURPOSE: To investigate the effect of intracameral triamcinolone on the control of inflammation with rupture of the posterior lens capsule during cataract surgery in rabbit eyes. METHODS: Twenty rabbit eyes were subjected to experimentally induced rupture of the posterior lens capsule and prolapse of the vitreous body into the anterior chamber. After anterior vitrectomy with and without triamcinolone, aqueous flare was measured with a laser flare meter on days 1, 3, 7, 14 and 28. RESULTS: Vitrectomized eyes with triamcinolone showed a less marked increase in postoperative aqueous flare intensity on days 14 and 28 than did those without triamcinolone (p<0.05). CONCLUSIONS: Intracameral injection of triamcinolone was beneficial for visualizing the prolapsed vitreous in the anterior chamber and for helping to control the postoperative inflammation without adverse effects.

The Effect of Intracameral Triamcinolone Acetonide Injection on the Cornea in Rabbits

PURPOSE: To evaluate the safety and effects of intracameral triamcinolone acetonide injection in rabbit corneas. METHODS: Triamcinolone acetonide in the amounts of 0.5, 1, and 2 mg was injected into the anterior chamber of rabbit eyes, and intraocular pressure, corneal thickness, and endothelial cell counts were evaluated on days 1, 3, 7, 14, and 28. Twenty-eight days after triamcinolone acetonide injection, the eyes were enucleated and examined after TUNEL staining. RESULTS: No statistically significant differences were found among control, 0.5, and 1 mg triamcinolone-injected eyes in central corneal thickness, endothelial cell density, pleomorphism, and polymegathism. There was no difference between 2 mg triamcinolone-injected eyes and control eyes for corneal thickness and cell density, but there were statistically significant differences between these two groups for pleomorphism (p<0.05) and polymegathism (p<0.05). CONCLUSIONS: The results of this study suggested that intracameral injections of 0.5~1 mg of triamcinolone acetonide are beneficial and cause no toxic effects on corneas.