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Intracameral corticosteroid does not increase risk of glaucoma after infantile cataract surgery
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Use of adjunctive intracameral preservative-free dexamethasone did not increase the risk of glaucoma after infantile cataract surgery, a study found. In addition, it may protect against anterior membrane formation.
“These results indicate that the endothelium was not affected to a clinically significant degree and that the rate of early-onset glaucoma was not increased,” the study authors said.
The retrospective study included 24 eyes of 18 patients with a mean age of 3 months at the time of surgery.
Lensectomy with automated irrigation and aspiration was performed through two corneal incisions. Posterior capsulotomy and anterior vitrectomy were also performed.
At the end of surgery, patients received intracameral injections of 0.4 mg preservative-free dexamethasone, subconjunctival injections of 4 mg betamethasone and 62.5 mg/0.5 mL cefuroxime, and orbital floor injections of up to 1 mL (40 mg) triamcinolone.
Patients also received bolus injections of acetazolamide (4 mg/kg four times daily) at the end of surgery and oral or intravenous acetazolamide (4 mg/kg four times daily) for 24 hours postoperatively.
The median follow-up interval was 38 months.
During the follow-up period, no eyes developed glaucoma. Four eyes developed transient postoperative ocular hypertension and were treated with antihypertensive medications.
No anterior membranes were identified during follow-up, but a second procedure was performed in 14 eyes to clear posterior visual axis opacification a mean 6.4 months postoperatively.
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