Original articleComparison Between Intravitreal and Orbital Floor Triamcinolone Acetonide After Phacoemulsification in Patients With Endogenous Uveitis
Section snippets
Patients and Methods
In this monocenter, prospective, randomized clinical trial, 40 patients (40 eyes) were included. All patients had vision-limiting cataract in the presence of chronic endogenous uveitis. All patients underwent phacoemulsification with posterior chamber acrylic foldable IOL implantation. No inflammation should have been present for at least three months before surgery. Known steroid responders, diabetics, and patients complaining of other ocular disorders were excluded.
Patients were randomly
Results
The two groups did not differ regarding age, gender, cataract score, presence of posterior synechiae (Group 1, n = 10; Group 2, n = 11), anatomic uveitis form, and associated diseases. The most common systemic diseases were sarcoidosis, spondylarthritis, and chronic inflammatory bowel disease. Differences between groups concerning BCVA (logMAR), systemic immunosuppression, laser flare values, mean foveal thickness (OCT), and CME before surgery were marginal (Table 1). In Group 1, 50% of
Discussion
Dada and Okhravi recently reported satisfactory visual outcome after intravitreal triamcinolone (TA) treatment in patients with endogenous uveitis after phacoemulsification, and Dada observed an anti-inflammatory effect comparable to that provided by oral prednisolone (1 ml/kg/d).5, 7 Local application of steroids appears to be particularly attractive, as the probability of systemic side effects is lower. For intravitreal TA, particularly high intraocular steroid levels, but also several side
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Cited by (33)
Efficacy and safety of intravitreal and periocular injection of corticosteroids in noninfectious uveitis: a systematic review
2022, Survey of OphthalmologyCitation Excerpt :The results of efficacy and safety outcomes are reported in detail in Tables 2 and 3, and summarized in Fig. 3. The intravitreal injection of triamcinolone acetonide was compared with the orbital floor injection of triamcinolone acetonide (2 studies, a RCT40 and a retrospective study41), with the posterior sub-Tenon injection of triamcinolone acetonide (2 studies, a RCT8 and a retrospective cohort38) and with periocular injections of triamcinolone acetonide (1 study48). Both studies comparing the intravitreal injection (4 mg) of triamcinolone acetonide with the orbital floor injection (40 mg) of triamcinolone acetonide reported a significantly higher improvement in macular edema at 3 months in the intravitreal triamcinolone acetonide injection group.
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2017, Journal of Cataract and Refractive SurgeryCitation Excerpt :The small number of patients receiving sub-Tenon steroids might have prevented the identification of significant differences between these patients. In a study of patients with chronic uveitis who had phacoemulsification with intraoperative 4 mg intravitreal triamcinolone versus 40 mg orbital floor triamcinolone,28 anterior chamber inflammation at 1 month and CME were improved significantly in the intravitreal group compared with the orbital floor group. In another study of 30 uveitic eyes that had cataract surgery with 4 mg intravitreal triamcinolone injected at the end of surgery,29 postoperative inflammation was controlled in all eyes for at least 3 months after surgery.
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