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Zhou T, Yang M, Zhang J, Zhang G, Kang L, Guan H. Efficacy of the efficacy between dexamethasone versus triamcinolone acetonide after cataract surgery: A systematic review and meta-analysis. Medicine (Baltimore) 2024; 103:e37584. [PMID: 38847669 PMCID: PMC11155516 DOI: 10.1097/md.0000000000037584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/22/2024] [Indexed: 06/10/2024] Open
Abstract
PURPOSE To evaluate the clinical effects between dexamethasone and triamcinolone acetonide (TA) after phacoemulsification and intraocular lens implantation among cataract patients. METHODS Pubmed, Embase, and the Cochrane Library were searched for studies published up to August 2020. The primary outcome was intraocular pressure. The secondary outcomes were the logarithm of the minimum angle of resolution (logMAR), anterior chamber cell, and anterior chamber flare. The pooled effect sizes were expressed as weighted mean differences (WMDs) or standardized mean differences (SMDs) of 95% confidence intervals (95% CIs). Cochrane Collaboration risk of bias tool and Newcastle-Ottawa scale criteria were used for the quality assessment of included studies. RESULTS Seven relevant studies met the inclusion criteria. For the primary outcome, there was no significant difference between TA injection and dexamethasone in comparing intraocular pressure (IOP) (SMD = 0.22, 95% confidence interval [CI] [-0.29, 0.73], P = .408; I² = 86.9%) in the first day after treatment and last day of assessment. For the secondary outcomes, the logMAR (WMD = 0.01, 95% CI [-0.06, 0.08]) and the anterior chamber flare (SMD = 0.08, 95% CI [-0.01, 0.18], P = .087; I² = 0%) showed no differences. However, the amount of anterior chamber cells (SMD = -0.21, 95% CI [-0.42, -0.01], P = .044; I² = 0%) in the TA injection on the first day postoperative was higher than for dexamethasone. After treatment, there was no difference between the 2 groups. CONCLUSIONS This study supports that there were no differences in IOP, logMAR, and anterior chamber flare between TA injection and dexamethasone among cataract patients. TA injection treatment on the first day showed higher amounts of anterior chamber cells than with dexamethasone.
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Affiliation(s)
- Tianqiu Zhou
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Mei Yang
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Junfang Zhang
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Guowei Zhang
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Lihua Kang
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Huaijin Guan
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
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Liu Z, Lu D, Pang M, Li J, Liu Y, Shi H, Liu G, Jin Y. The Effect of Intracameral Triamcinolone Acetonide on Controlling Common Complications following Phacoemulsification in Dogs. Animals (Basel) 2024; 14:547. [PMID: 38396515 PMCID: PMC10885903 DOI: 10.3390/ani14040547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/28/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
The intracameral injection of triamcinolone acetonide (TA) has achieved favorable clinical effects in controlling intraocular inflammatory reactions in humans after cataract surgery. However, the effect of this method remains unclear in veterinary practice. In this paper, 18 dogs with bilateral cataracts were randomly divided into three groups, with 6 dogs in each group. Phacoemulsification and intraocular lens implantation were performed on the 36 eyes of these dogs. A total of 0.1 mL of TA solution was injected into the oculus dexter (OD) anterior chambers. All oculus sinister (OS) anterior chambers of these dogs were used as controls. The results demonstrated that the corneal edema severity scores of the OD (1.5 mg TA) were lower than those of the OS from the 1st to 7th day after surgery, with a significant difference on the 3rd day after surgery (p = 0.033). The corneal edema severity scores in the OD (1.5 mg TA) were significantly lower than those in the OD (0.5 mg TA) on the 3rd day after surgery (p = 0.036). The aqueous humor protein concentration of the OD (1.5 mg TA) had a lower concentration than the OS on the 1st day after surgery (p = 0.004). Furthermore, on the 5th and 10th days, the aqueous humor protein concentration of the OD (1.5 mg TA) was lower than that of the OS (p = 0.038 and p = 0.044, respectively). The aqueous humor PGE2 concentration of the OD (1.5 mg TA) had a lower concentration than the OS on the 1st day after surgery (p = 0.026). The aqueous humor PGE2 concentrations in the OD (1.0 mg TA) and OD (1.5 mg TA) were lower compared to that in the OD (0.5 mg TA) on the 1st day after surgery (p = 0.041 and p = 0.037, respectively). It was demonstrated that TA-based treatment can be safely employed to effectively control common complications after phacoemulsification in dogs.
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Affiliation(s)
- Zichen Liu
- College of Veterinary Medicine, China Agricultural University, No. 2 Yuanmingyuan West Rd, Haidian District, Beijing 100193, China
| | - Di Lu
- College of Veterinary Medicine, China Agricultural University, No. 2 Yuanmingyuan West Rd, Haidian District, Beijing 100193, China
| | - Mo Pang
- College of Veterinary Medicine, China Agricultural University, No. 2 Yuanmingyuan West Rd, Haidian District, Beijing 100193, China
| | - Jing Li
- College of Veterinary Medicine, China Agricultural University, No. 2 Yuanmingyuan West Rd, Haidian District, Beijing 100193, China
| | - Yue Liu
- College of Veterinary Medicine, China Agricultural University, No. 2 Yuanmingyuan West Rd, Haidian District, Beijing 100193, China
| | - Hao Shi
- College of Veterinary Medicine, China Agricultural University, No. 2 Yuanmingyuan West Rd, Haidian District, Beijing 100193, China
| | - Gang Liu
- College of Veterinary Medicine, China Agricultural University, No. 2 Yuanmingyuan West Rd, Haidian District, Beijing 100193, China
| | - Yipeng Jin
- College of Veterinary Medicine, China Agricultural University, No. 2 Yuanmingyuan West Rd, Haidian District, Beijing 100193, China
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Gautam M, Gupta R, Singh P, Verma V, Verma S, Mittal P, Karkhur S, Sampath A, Mohan RR, Sharma B. Intracameral Drug Delivery: A Review of Agents, Indications, and Outcomes. J Ocul Pharmacol Ther 2023; 39:102-116. [PMID: 36757304 DOI: 10.1089/jop.2022.0144] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
An intracameral (IC) injection directly delivers the drug into the anterior chamber of the eye. This targeted drug delivery technique overcomes the ocular barriers and offers a high therapeutic concentration of medication at the desired site and consequently better clinical outcomes. IC drug delivery is a safe and effective modality with many advantages over topical delivery. These include excellent bioavailability, reduced systemic risk, and minimal ocular toxicity. Agents delivered via IC injection have shown promising results against infection, inflammation, ocular hypertension, and neovascularization. Current literature shows that IC antibiotics, including cefuroxime, vancomycin, and moxifloxacin, are routinely used for prophylaxis of endophthalmitis. Other drugs available for IC use are steroids, anesthetics, mydriatics, miotics, antivascular endothelial growth factor, antiglaucoma, and alkylating agents. Introduction of sustained-release devices containing dexamethasone or Bimatoprost in anterior chamber via IC route has the potential in treating ocular inflammation and raised intraocular pressure. The complications such as hemorrhagic occlusive retinal vasculitis and toxic anterior segment syndrome have been documented with IC prophylaxis but are rare. In this review, we provide an overview of available IC drugs, their pharmacokinetics, the spectrum of activity, dosage and preparation, prophylactic and therapeutic usage, clinical efficacy, and safety profiles.
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Affiliation(s)
- Megha Gautam
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, India
| | - Rituka Gupta
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, India
| | - Priti Singh
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, India
| | - Vidhya Verma
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, India
| | - Sunil Verma
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, India
| | - Parul Mittal
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, India
| | - Samendra Karkhur
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, India
| | - Ananyan Sampath
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, India
| | - Rajiv R Mohan
- Department of Ophthalmology and Molecular Medicine, University of Missouri, Columbia, Missouri, USA
| | - Bhavana Sharma
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, India
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Shi Y, Oatts J, Tian J, Qiao C, Zhang Q, Han Y, Wang N. Low-dose transscleral cyclophotocoagulation with subsequent phacoemulsification in the treatment of prolonged acute primary angle closure. Br J Ophthalmol 2023; 107:221-226. [PMID: 34462269 PMCID: PMC9887366 DOI: 10.1136/bjophthalmol-2021-318880] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 08/15/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND To explore the outcomes and mechanisms of intraocular pressure (IOP) control using low-dose transscleral cyclophotocoagulation (LDTSCP) followed by phacoemulsification in patients with prolonged acute primary angle closure (APAC). METHODS Patients with prolonged APAC refractory to all other treatment modalities were prospectively recruited, and underwent LDTSCP (10 shots, 2 s duration, 120° treatment with the energy starting at 1500 mW and titrated to the level with audible burst but not exceeding 2000 mW) and anterior chamber paracentesis 1 week prior to phacoemulsification with intraocular lens implantation and viscogoniosynechiolysis. Postoperative IOP, vision, anatomic changes on anterior segment optical coherence tomography and complications were recorded. RESULTS Twenty eyes with prolonged APAC were recruited. Median follow-up was 12 months (range 9-18), at which point the vision in all eyes had improved and IOP was ≤17 mm Hg on no antiglaucoma medications. Following LDTSCP at postoperative day (POD) 1, IOP decreased in all eyes to a median 15 mm Hg (range: 6-28 mm Hg). Post-LDTSCP supraciliary effusion (SCE) occurred in 90% of eyes on POD1 or POD7 and ciliary body defect (CBD) was detected in 30% of eyes and resolved in all cases by postoperative month 1. Lower post-LDTSCP IOP was associated with more number of bursts (r=-0.558, p=0.011) and higher grade of SCE (r=-0.877, p<0.001), but not with total energy (p=0.240). Eyes with CBD (p=0.018) and a higher number of bursts (r=0.657, p=0.002) had higher grade SCE. CONCLUSIONS LDTSCP-induced SCE may explain the post-LDTSCP IOP reduction seen in eyes with prolonged APAC. LDTSCP instead of traditional more extensive treatment, was sufficient to provide a relatively safe and effective bridge therapy prior to phacoemulsification. TRIAL REGISTRATION NUMBER Chinese Clinical Trials Registry (ChiCTR1900023567).
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Affiliation(s)
- Yan Shi
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Julius Oatts
- Department of Ophthalmology, University of California, San Francisco School of Medicine, San Francisco, California, USA
| | - Jiaxin Tian
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Chunyan Qiao
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Qing Zhang
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ying Han
- Department of Ophthalmology, University of California, San Francisco School of Medicine, San Francisco, California, USA
| | - Ningli Wang
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Chiquet C, Aptel F, Creuzot-Garcher C, Berrod JP, Kodjikian L, Massin P, Deloche C, Perino J, Kirwan BA, de Brouwer S, Combette JM, Behar-Cohen F. Postoperative Ocular Inflammation: A Single Subconjunctival Injection of XG-102 Compared to Dexamethasone Drops in a Randomized Trial. Am J Ophthalmol 2017; 174:76-84. [PMID: 27810317 DOI: 10.1016/j.ajo.2016.10.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 10/21/2016] [Accepted: 10/22/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE To evaluate the efficacy and safety of XG-102 (brimapitide) compared to dexamethasone eye drops in the treatment of postoperative ocular inflammation. DESIGN Multicenter, randomized, parallel group, double-masked, noninferiority clinical trial. METHODS Patients who underwent anterior and posterior segments combined surgery or glaucoma surgery or complex posterior segment surgery were eligible to participate. Patients were administered a single subconjunctival injection of 250 μL XG-102 90 μg (n = 47) or 900 μg (n = 48) or placebo (n = 50) at the end of ocular surgery. Subconjunctival injection for each group (XG-102 90 μg, XG-102 900 μg, or placebo) was followed by eye drops instilled 4 times per day for 21 days with placebo, placebo, or dexamethasone solution, respectively. The primary outcome measure was anterior chamber cell grades at day 28 comparing XG-102 900 μg with dexamethasone. RESULTS The anterior cell grades for both XG-102 groups were noninferior to dexamethasone (-0.054 anterior cell grade [95% confidence interval -0.350-0.242]; P < .001 for noninferiority) for XG-102 900 μg and -0.086 anterior cell grade (95% confidence interval -0.214-0.385; P = .003 for noninferiority) for XG-102 90 μg. Rescue medication was introduced for 10 (21%), 7 (15%), and 2 (4%) patients allocated to the XG-102 90 μg, XG-102 900 μg, and dexamethasone groups, respectively. The difference between XG-102 90 μg and dexamethasone was statistically significant (P = .013). The number of patients for whom adverse events were reported and the nature of the events reported was similar between the 3 treatment groups. CONCLUSIONS A single subconjunctival injection of XG-102 at the end of ocular surgery is noninferior to dexamethasone eye drops in the treatment of postoperative ocular inflammation.
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Clinical outcomes after injection of a compounded pharmaceutical for prophylaxis after cataract surgery: a large-scale review. Curr Opin Ophthalmol 2017; 28:73-80. [PMID: 27653606 PMCID: PMC5145248 DOI: 10.1097/icu.0000000000000329] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Purpose of review To evaluate relevant clinical outcomes following a transzonular intravitreal injection of a compounded triamcinolone–moxifloxacin–vancomycin (TMV) formulation for postoperative prophylaxis after cataract surgery in a retrospective review of medical records from a private practice, single-specialty ambulatory center in New Jersey, USA. Recent findings The analysis included 1541 cases from 922 patients who underwent cataract surgery with an intravitreal injection of TMV from November 2013 to December 2014. Cataract surgery was performed by a standard clear corneal phacoemulsification technique. Transzonular injection was used to deliver TMV directly into the anterior vitreous after implantation of an intraocular lens. Summary There were no major intraoperative complications associated with the transzonular injection technique. There were no cases of postoperative endophthalmitis. Nearly 92% of cases (n = 1413/1541) did not require supplemental medication after surgery. The rate of breakthrough inflammation at Days 14–21 was 9.2% (n = 132/1429). The rate of visually significant postoperative cystoid macular edema was 2.0% (n = 28/1429). The rate of clinically significant postoperative intraocular pressure increase was low: 0.9% (n = 13/1425) of cases had an at least 10 mmHg increase at Days 14–21 or 90. Four of these cases had intraocular pressure at least 30 mmHg. The rates of infection and inflammation reported in this retrospective review of a transzonular injection of TMV for prophylaxis after cataract surgery appear similar to reported rates with alternative prophylactic therapies such as topical drops. The transzonular injection of TMV may have advantages in terms of patient compliance.
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Alagöz N, Alagöz C, Yıldırım Y, Yeşilkaya C, Altan Ç, Bozkurt E, Şatana B, Başarır B, Taşkapılı M. The Effect of Adjuvant Intracameral Triamcinolone Acetonide on the Surgical Results of Trabeculectomy with Mitomycin C. Turk J Ophthalmol 2017; 46:169-174. [PMID: 28058152 PMCID: PMC5200822 DOI: 10.4274/tjo.88785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Accepted: 08/22/2015] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES To evaluate the effect of adjuvant intracameral triamcinolone acetonide (TA) on the surgical results of trabeculectomy with mitomycin C. MATERIALS AND METHODS All consecutive trabeculectomy cases performed in the glaucoma clinic between July 2012 and December 2013 were retrospectively reviewed from the patient charts. Only those with follow-up of 12 months or longer were included. Patients with intraoperative intracameral TA (study group, n=19) were compared to those without TA (control group, n=21) in terms of surgical success, intraocular pressure (IOP) change, medication use and complications. RESULTS Forty eyes of 31 patients (21 male/10 female, mean age 64.2±13.8 years) were included in the study. The mean follow-up period was 20.9±5.1 months and 20.7±6.7 months in the study and control groups, respectively (p=0.830). Baseline IOP was 26.4±9.9 and 25.2±7.6 mmHg (p=0.979), and final IOP was 12.7±2.6 and 13.6±3 mmHg in both groups respectively (p=0.226). At the final follow-up, complete success was observed in 68.4% and 52.4% of the study and control groups (p=0.349) and anti-glaucoma medication was used by 31.6% (mean number of medications: 0.79±1.2) and 47.6% (mean number of medications: 1.33±1.7), respectively (p>0.05). Bleb encapsulation, leakage, suture-lysis and hypotony rates were similar in both groups (for all, p>0.05). Cataract progression was noted in six (35.3%) and in five (26.3%) of the phakic eyes in the study and control groups, respectively (p=0.720). CONCLUSION When used intracamerally, TA did not increase the complication rate in trabeculectomy surgery. Although the group that received TA showed lower IOP levels, use of fewer medications and fewer eyes requiring medication, the differences did not reach significance.
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Affiliation(s)
- Neşe Alagöz
- Beyoğlu Eye Training and Research Hospital, İstanbul, Turkey
| | - Cengiz Alagöz
- Beyoğlu Eye Training and Research Hospital, İstanbul, Turkey
| | - Yusuf Yıldırım
- Beyoğlu Eye Training and Research Hospital, İstanbul, Turkey
| | - Ceren Yeşilkaya
- Beyoğlu Eye Training and Research Hospital, İstanbul, Turkey
| | - Çiğdem Altan
- Beyoğlu Eye Training and Research Hospital, İstanbul, Turkey
| | | | - Banu Şatana
- Beyoğlu Eye Training and Research Hospital, İstanbul, Turkey
| | - Berna Başarır
- Beyoğlu Eye Training and Research Hospital, İstanbul, Turkey
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Gungor SG, Bulam B, Akman A, Colak M. Comparison of intracameral dexamethasone and intracameral triamcinolone acetonide injection at the end of phacoemulsification surgery. Indian J Ophthalmol 2016; 62:861-4. [PMID: 25230962 PMCID: PMC4185164 DOI: 10.4103/0301-4738.141045] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose: To compare the results of intracameral dexamethasone and intracameral triamcinolone acetonide injection in patients that underwent cataract surgery with phacoemulsification. Materials and Methods: Sixty eyes of 60 patients that underwent cataract surgery with phacoemulsification were randomized into two groups. Preoperative visual acuity of all patients was 0.5 or lower and intraocular pressures were under 21mmHg. After surgery, eyes in group 1 (30 eyes) were injected with 0.4 mg/0.1 ml dexamethasone into the anterior chamber, and eyes in group 2 (30 eyes) were injected with 2 mg/0.05 ml triamcinolone acetonide into the anterior chamber. All eyes received standard postoperative prednisolone acetate and moxifloxacin eye drops. The biomicroscopic evaluation, visual acuity, and intraocular pressure measurements were done at baseline (preoperatively) and on postoperative days 1, 7 and 30. Results: There were no statistically significant differences in mean visual acuity, the amount of anterior cells and flare between the two groups (P ≥ 0.05). Mean intraocular pressure values at postoperative first day were significantly higher in group 2 than in group 1 (P = 0.009). The mean intraocular pressures on days 7 and 30 after surgery were not statistically different between the two groups (P ≥ 0.05). Conclusions: Intracameral dexamethasone and intracameral triamcinolone acetonide were similarly effective in controlling postoperative inflammation following phacoemulsification. However, the intraocular pressures on postoperative first day were higher in patients receiving intracameral triamcinolone acetonide. The highest intraocular pressure in triamcinolone acetonide group was 24 mmHg, and stabilized in a few days, therefore using triamcinolone acetonide may impose a minimal risk to patients. Nevertheless, intracameral dexamethasone seems to be a better alternative to apply at the end of surgery to suppress the inflammation during the first 24 hours.
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Affiliation(s)
- Sirel Gur Gungor
- Department of Ophthalmology, Faculty of Medicine, Başkent University, Ankara, Turkey
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Koval MS, Moster MR, Freidl KB, Waisbourd M, Jain SG, Ichhpujani P, Myers JS, Pro MJ. Intracameral triamcinolone acetonide in glaucoma surgery: a prospective randomized controlled trial. Am J Ophthalmol 2014; 158:395-401.e2. [PMID: 24794283 DOI: 10.1016/j.ajo.2014.04.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 04/25/2014] [Accepted: 04/28/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate the efficacy and safety of intracameral triamcinolone acetonide (TA) in glaucoma surgery. DESIGN Prospective randomized clinical trial. METHODS SETTING Institutional-Wills Eye Hospital. STUDY POPULATION Patients undergoing trabeculectomy (with or without cataract surgery) or tube shunt surgery. INTERVENTION Patients were randomized to receive intracameral TA or balanced salt solution at the end of surgery. Follow-up time was 6 months. MAIN OUTCOME MEASURES Intraocular pressure, visual acuity, inflammation measured by slit-lamp examination and laser flare meter, cataract grading, bleb appearance, dry eye scores, use of supplemental medical therapy, surgical success, and rate of complications. RESULTS Seventy-seven patients were enrolled in the study, including 37 in the TA group and 40 in the control group. There were no significant differences in success rates between the 2 groups (P=.60). Intraocular pressure and medication use were similar between the groups for each follow-up visit. Dry eye scores were lower in the TA group at month 1 (P=.042), while flare scores were higher in the TA group on day 1 (P=.015) but lower at month 1 (P=.044). The complication rates were higher in the TA group on day 1 (P=.04). All other outcome measures were similar for both groups. CONCLUSIONS Intracameral TA did not affect the success rates or change the complication rates of glaucoma surgery.
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Ventura MC, Ventura BV, Ventura CV, Ventura LO, Nosé W. Congenital cataract surgery with intracameral triamcinolone: pre- and postoperative central corneal thickness and intraocular pressure. J AAPOS 2012; 16:441-4. [PMID: 23084381 DOI: 10.1016/j.jaapos.2012.06.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Revised: 06/10/2012] [Accepted: 06/18/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE To evaluate the change in intraocular pressure (IOP) and central corneal thickness (CCT) of children who underwent congenital cataract surgery with injection of triamcinolone acetonide into the anterior chamber at the end of the procedure. METHODS Fifty-three eyes of 34 children <2 years of age who underwent congenital cataract surgery with injection of 1.2 mg/0.03 mL of preservative-free triamcinolone acetonide into the anterior chamber at the end of the procedure were included in this study. IOP and CCT were measured preoperatively and at a mean of 2 and 12 months' follow-up. RESULTS The mean IOP was 8.7 ± 0.4 mm Hg preoperatively, 8.4 ± 0.6 mm Hg at the 2-month follow-up, and 8.1 ± 0.3 mm Hg at the 12-month follow-up. The mean CCT was 562 ± 11 μm preoperatively, 563 ± 10 μm at the 2-month follow-up, and 570 ± 10 μm at the 12-month follow-up. There was no significant change in either pre- or postoperative IOP (P = 0.700) or CCT (P = 0.419) over the study period. CONCLUSIONS Injection of 1.2 mg triamcinolone acetonide at the end of congenital cataract surgery in children <2 years of age did not significantly affect IOP or CCT in the first year after surgery.
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Abstract
PURPOSE To report a technique for judging needle depth in the corneal stroma during big-bubble deep anterior lamellar keratoplasty (DALK). METHODS With the anterior chamber full of air, a dilute suspension of washed triamcinolone crystals is injected to "wash" over the air bubble. Some crystals are trapped between air and endothelium, making the posterior limit of the cornea easier to identify. The needle is then inserted into deep stroma, and big-bubble DALK is performed in the usual manner. RESULTS This technique was used in 10 keratoconic eyes undergoing big-bubble DALK. No adverse effects of triamcinolone use were found in any eyes. CONCLUSIONS This technique provides another option for surgeons who wish to accurately judge needle depth during big-bubble DALK.
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Cleary CA, Lanigan B, O'Keeffe M. Intracameral triamcinolone acetonide after pediatric cataract surgery. J Cataract Refract Surg 2010; 36:1676-81. [PMID: 20870112 DOI: 10.1016/j.jcrs.2010.04.038] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Revised: 04/20/2010] [Accepted: 04/20/2010] [Indexed: 10/19/2022]
Abstract
PURPOSE To assess the use of preservative-free intracameral triamcinolone as an adjunct to topical steroidal agents after pediatric cataract surgery. SETTING Children's University Hospital, Dublin, Ireland. DESIGN Retrospective case series. METHODS From the 2008 to 2009, intracameral preservative-free triamcinolone 4 mg/0.1 mL (Triesence) was used immediately after cataract surgery. Clinical indices of anterior segment inflammation were assessed at 1, 7, 14, 21 days and at 6 weeks postoperatively. RESULTS There were no complications secondary to triamcinolone use in 36 eyes of 26 children. In all but 1 case, intracameral triamcinolone was highly effective in controlling postoperative inflammation after pediatric cataract surgery, resulting in quiet eyes with few inflammatory signs (grade 0 to 1). CONCLUSION Intracameral triamcinolone provided a safe and useful adjunct to topical steroid drops after pediatric cataract surgery.
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Affiliation(s)
- Catherine A Cleary
- Doheny Eye Institute, University of Southern California, Los Angeles, California, USA
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