Efficacy of Preoperative Posterior Sub-Tenon Injection of Triamcinolone Acetate to Control Postoperative Cataract Surgery Inflammation in Noninfectious Uveitis Patients

Budsarat Suleesathira MD*, Narumon Keorochana MD*, Raveewan Choontanom MD*

Affiliation : * Department of Ophthalmology, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand

Objective : To evaluate the efficacy of a single preoperative posterior sub-Tenon’s capsule triamcinolone acetonide injection in treating ocular inflammation after cataract surgery. Material and Method: This monocenter study employed a retrospective descriptive study of 30 eyes (23 patients) with non-infectious uveitis receiving a single posterior sub-Tenon’s capsule triamcinolone acetonide (PSTA 40 mg) injection before undergoing phacoemulsification with intraocular lens (IOL) implantation. Outcome measures were anterior chamber (AC) cell, intraocular pressure (IOP, Goldman applanation tonometry), best-corrected visual acuity (BCVA), and cystoid macular edema (CME) over a 3-month follow-up period.
Results : Thirty eyes of 23 patients completed three months after cataract surgery were included in the present study. Sixty-three-point-three percent of patients had an active inflammation (≥1+ cells in the AC) at postoperative day 7, which significantly decreased over the follow-up period (p = 0.002 at day 30 and p<0.001 at day 90). Ocular inflammation was controlled in 90% of patient at the end of the follow-up period. Mean BCVA compared with baseline improved significantly at each visit (p<0.001). The difference of IOP between baseline and each visit were not significant. Macular edema was observed among 10%.
Conclusion : A single preoperative posterior sub-Tenon injection of triamcinolone acetate was effective in controlling postoperative inflammation, decreasing incidence of macular edema, posterior synechiae formation, and rising IOP compared with other studies. It appears to be an alternative modality for preoperative medication or adjunct therapy to the conventional steroid management in treating ocular inflammation after cataract surgery.

Keywords : Preoperative cataract surgery, Uveitis surgery, Triamcinolone acetate

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