Anterior peribulbar triamcinolone acetonide injections may increase IOP, cataract risk

Retina. 2011;31(2):284-289.

Eyes with diabetic macular edema had an increased risk of elevated IOP and cataract development after anterior peribulbar injections of triamcinolone acetonide, a study said.

Subjects were randomized to receive either focal/grid photocoagulation, anterior injection of 20-mg triamcinolone acetonide, anterior injection followed by laser, posterior injection of 40-mg triamcinolone acetonide alone, or posterior injection followed by laser.

Of the 96 eyes that completed the 2-year follow-up period, two eyes (8%) in the laser group, 11 eyes (31%) in the anterior groups and six eyes (17%) in the posterior groups had IOP increases that were greater than 10 mm Hg from baseline.

The risk of ptosis development was greater in the posterior injection group, the study said.

At 2-year follow-up, none of the phakic eyes in the laser group had undergone cataract surgery, but five eyes (17%) in the anterior groups and one eye (3%) in the posterior groups had surgery.

The authors noted the sample size was not large enough to conduct definitive statistical analyses. However, the results could be applied to other conditions that are treated with peribulbar corticosteroids, they said.