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Intravitreal triamcinolone controlled inflammation in cataract patients with uveitis
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LONDON – Intravitreal triamcinolone is safe and effective for controlling inflammation after phacoemulsification and IOL implantation in patients with uveitis, according to a physician speaking here.
Because cataract surgery can exacerbate uveitis, “the inflammation must be controlled preoperatively for at least 3 months,” said Narciss Okhravi, FRCOphth, PhD, speaking here at the Moorfields Bicentenary scientific meeting.
“You have to make sure the eyes are quiet before surgery,” said Dr. Okhravi, of Moorfields Eye Hospital.
Intravitreal triamcinolone is “better for patients with diabetes, osteoporosis and peptic ulcers,” but cannot be used with steroid responders, she stressed.
For patients with uveitis, 4 mg of 0.1 mL intravitreal triamcinolone is injected through the pars plana after cataract surgery, Dr. Okhravi said. She reported results in 17 eyes at 1 day, 1 week, 1 and 3 months after cataract surgery.
Of the 17 eyes, 16 underwent uncomplicated phaco and IOL implantation. The mean preoperative visual acuity was 6/36. On day 1 postop, 82% had a mean VA of 6/12, and vision stabilized by month 3, she said.
Whether patients with uveitis undergo phaco or extracapsular cataract extraction, about the same number will develop cystoid macular edema, Dr. Okhravi said. In her study, with the use of intravitreal triamcinolone, no eye developed CME by month 3 postop.
Three patients experienced a rise in IOP to more than 24 mm Hg, but “they were all off medication by the third month,” she said.