Surgeons increasingly using intracameral triamcinolone

LONDON — An increasing number of surgeons are using or are interested in using intracameral triamcinolone during complex anterior chamber surgery, according to a surgeon speaking here.

For some time after the technique was first described 4 years ago, there had been some reluctance in using it, mainly due to fear of complications and misconceptions regarding preparation of the injection, said Romesh Angunawela, MD. Dr. Angunawela presented a video on the topic at the European Society of Cataract and Refractive Surgeons meeting.

"In actual fact, triamcinolone for anterior segment use is easy to prepare, doesn't need filtration, and there is no evidence that it may cause significant complications," he said. "It is a simple technique for visualizing the vitreous and guiding your vitrectomy, and ultimately it makes complicated cataract surgery safer."

Intracameral triamcinolone is invaluable for determining not only the presence but also the absence of vitreous in the anterior segment, he said.

"It visualizes the vitreous strands so that you can guide your vitrector exactly to where they are and deal with them completely and safely under visualization. It's a guided technique, much safer than just sweeping around with the vitrector. In other cases, it may show that there is no vitreous where you suspected there might have been, and unnecessary anterior vitrectomy can be avoided," he noted.

Dr. Angunawela's video demonstrated a wide spectrum of intracameral triamcinolone applications, including visualizing and selectively removing the vitreous following zonular dehiscence, posterior capsule rupture and secondary IOL implantation. The absence of suspected vitreous was confirmed in high-risk cases where the anterior hyaloid face was intact.