Triamcinolone-assisted vitrectomy in pediatric cataract surgery: intraoperative effectiveness and postoperative outcome.

PURPOSE: To evaluate intraoperative effectiveness and postoperative outcome of intracameral, preservative-free triamcinolone acetonide in pediatric cataract surgery. METHODS: A prospective, interventional, observational case series was performed in children undergoing congenital cataract surgery. Three standardized applications of triamcinolone acetonide were used. Postoperatively, IOP, pachymetry, glaucoma, posterior synechiae, cell deposits, and posterior capsule opacification were studied at 1 week, 1 month, and 12 months after surgery. RESULTS: Mean age at the time of surgery was 14.8 +/- 12.2 months. Of 43 eyes, 5 were kept aphakic and 38 received IOL implantation. After manual posterior continuous curvilinear capsulorhexis and the first injection of triamcinolone, the anterior vitreous face disturbance was visualized as free-floating vitreous strands going into the incision in 18.6% of eyes (8 of 43). Triamcinolone was injected a second time after anterior vitrectomy: residual vitreous strands were identified and removed in 7 of these 8 eyes. Triamcinolone was used for a third time after IOL implantation: residual vitreous strands were identified in 5.3% of eyes (2 of 38). Mean IOP was 12.2 +/- 2.2 mm Hg preoperatively and was 13.6 +/- 3.2 at the 1 week follow-up visit, 12.8 +/- 2.8 at 1 month, and 12.4 +/- 2.0 mm Hg at 12 months. CONCLUSIONS: Preservative-free triamcinolone acetonide improved visualization of the vitreous during pediatric cataract surgery, thereby ensuring thorough and complete anterior vitrectomy. IOP was not affected, and no adverse postoperative results were observed.

Impact of high and low aspiration parameters on postoperative outcomes of phacoemulsification: randomized clinical trial.

PURPOSE: To compare the effects of fluidic parameters on the central corneal thickness (CCT), corneal endothelium, and anterior segment inflammation after phacoemulsification with longitudinal ultrasound. SETTING: Iladevi Cataract & IOL Research Center, Ahmedabad, India. METHODS: In this prospective randomized patient- and examiner-masked study, consecutive patients with age-related cataract were randomly assigned to Group 1 (low fluidic parameters: aspiration flow rate 25 cc/min; bottle height 70 cm and 90 cm; vacuum