Outcomes of congenital cataract surgery: intraoperative intracameral triamcinolone injection versus postoperative oral prednisolone

J Cataract Refract Surg. 2014 Apr;40(4):601-8. doi: 10.1016/j.jcrs.2013.09.011. Epub 2014 Feb 13.

Abstract

Purpose: To compare the outcomes of congenital cataract surgery using intraoperative intracameral triamcinolone versus postoperative oral prednisolone to modulate ocular inflammation.

Setting: Department of Congenital Cataract, Altino Ventura Foundation, Recife, Brazil.

Design: Randomized clinical trial.

Methods: Children younger than 2 years were randomly divided into 2 groups. The study group received an intraoperative intracameral injection of 1.2 mg/0.03 mL of triamcinolone acetonide. The control group (29 eyes) received 1 mg/kg per day of prednisolone syrup for 15 days postoperatively, which was then tapered over the following 2 weeks. Intraocular pressure (IOP), central corneal thickness (CCT), cell deposits on the intraocular lens (IOL), posterior synechiae, visual axis obscuration, additional surgical procedures, and IOL centration were assessed 12 months postoperatively.

Results: The mean patient age at surgery was 10.45 months±6.22 (SD) in the study group (31 eyes) and 10.0±6.15 months in the control group (29 eyes) (P=.779). In both groups, the mean IOP and CCT did not change significantly postoperatively (study group P=.922 and P=.149, respectively; control group P=.483 and P=.416, respectively). The groups had similar incidences of cell deposits (P=.517) and posterior synechiae (P=.247). No eye developed visual axis obscuration or had additional surgical procedures. All eyes had a clinically centered IOL.

Conclusion: One year postoperatively, the outcomes were similar with intraoperative intracameral triamcinolone injection and postoperative oral prednisolone for modulating inflammation after congenital cataract surgery.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Anterior Eye Segment / drug effects
  • Cataract / congenital*
  • Cataract Extraction*
  • Cornea / pathology
  • Corneal Pachymetry
  • Female
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / therapeutic use*
  • Humans
  • Infant
  • Injections, Intraocular
  • Intraocular Pressure / physiology
  • Intraoperative Care / methods
  • Lens Implantation, Intraocular*
  • Male
  • Postoperative Care / methods
  • Prednisolone / administration & dosage
  • Prednisolone / analogs & derivatives*
  • Prednisolone / therapeutic use
  • Treatment Outcome
  • Triamcinolone Acetonide / administration & dosage
  • Triamcinolone Acetonide / therapeutic use*
  • Uveitis, Anterior / prevention & control

Substances

  • Glucocorticoids
  • prednisolone acetate
  • Prednisolone
  • Triamcinolone Acetonide