Intravitreal versus Oral Steroids for Inflammation Control in Uveitic Patients Undergoing Cataract Surgery

Ocul Immunol Inflamm. 2023 Apr 21:1-6. doi: 10.1080/09273948.2023.2198598. Online ahead of print.

Abstract

Background: This prospective experimental study was conducted on 40 eyes of 40 patients with complicated uveitic cataracts to compare a single intraoperative intravitreal injection of triamcinolone acetonide (IVTA) with oral steroids for inflammation control after cataract extraction.

Methods: The IVTA group (19 eyes) received an intravitreal injection of 4 mg/0.1 ml triamcinolone acetonide intraoperatively, and the oral steroid group (19 eyes) received oral steroids peri-operatively. Two patients had to be excluded from the study because they underwent extracapsular cataract extraction (ECCE), instead of phacoemulsification.

Results: A statistically significant difference was observed in the anterior chamber cell and flare response between both groups initially, but by the last follow-up, this became insignificant. None of the patients in each group experienced a recurrence of uveitis nor developed cystoid macular edema. Five patients in the oral steroid group had IOP >21 mmHg post-operatively.

Conclusion: A single injection of 4 mg IVTA has similar efficacy to peri-operative oral steroid administration.

Keywords: Cataract; intravitreal; oral steroids; triamcinolone acetonide; uveitis.