Safety & efficacy of single subconjunctival triamcinolone 5 mg depot vs topical loteprednol post cataract surgery: less drop cataract surgery

Abstract

Aim: To do a randomized prospective interventional study for comparing the effects of a single subconjunctival triamcinolone acetonide (SCTA) injection to tapering topical loteprednol in patients undergoing phacoemulsification surgery under topical anesthesia.

Methods: A total of 400 patients were randomized into 2 groups; Group A (200 patients) received 5 mg SCTA at the end of surgery and topical ketorolac tromethamine (0.5%) with ofloxacin (0.3%) combination for 3wk. Group B (200 patients) received tapering topical loteprednol etabonate (0.5%) along with ofloxacin (0.3%) and ketorolac tromethamine (0.5%) for 3wk. Outcomes evaluated were intraocular pressure (IOP), anterior chamber cells/flare and macular oedema postoperatively at 1, 6 and 12wk.

Results: Baseline parameters were almost similar in both the groups. No statistical difference was seen between the preoperative and postoperative IOP values for Group A (P=0.82) and Group B (P=0.61) and postoperative IOP values in between both groups (P=0.14) at 1wk. Incidence of cells/flare postoperative was statistically not significant (P=0.82) in both groups at all follow up visits. Postoperative macular oedema was not observed at any follow up visit.

Conclusion: SCTA appears to be an effective alternative to prolong postoperative topical steroid use.

Keywords: cells/flare; intraocular pressure; less drop cataract surgery; loteprednol; phacoemulsification; subconjunctival triamcinolone acetonide.

Figure 1. Study profile of patient flow.

Figure 2. A peri-operative subconjunctival injection of triamcinolone acetonide.

Figure 3. Comparison of IOP values between patients who received peri-operative SCTA (Group A) and patients receiving postoperative topical loteprednol (Group B).