Intracameral Different Dosage Triamcinolone Acetonide Preventing Inflammation For Senile Cataract

Setting and ObjectiveGlucocorticoids began to restrain inflammation after cataract surgery from the 1950s, but presently it is mainly used for eye drops or sub-conjunctival injection, also reported peribulbar or retro-bubar injection, intravitreous injection, muscle injections. Although the long-term of glucocorticoid eyedrops to control postoperative inflammation is effective, but the long-term eye drops need patients' compliance, destroy tear film, causing dry eye, appear eye pain and discomfort, and even cause glaucoma. Therefore we need to take steps to reduce the long-term glucocorticoid eyedrops after cataract surgery.In recent years, triamcionlone acetonide (TA) as a kind of long acting glucocorticoid is used more widely in ophthalmic. Early it is used for intravitreous injection inside eye surgerye, to control retinitis, uveitis, optic neuritis, and treat macular by various causes, reduce inflammation, inhibit proliferative vitreoretinopathy and neovascularization of retina, choroidal and iris. Now many ophthalmologists domestic and overseas intracameral 2mg triamcinolone acetonide in congenital cataract surgery, complicate cataract surgery and traumatic cataract surgery to control the postoperative inflammation. By clinical observation, this study aims to explore the efficacy, safety and tolerability of intracameral 1mg/0.2ml,2mg/0.2ml of triamcinolone acetonide in controlling ocular inflammation in patients during age-related cataract surgery. Furthermore, comparing with long-term topical prednisolone acetate for patients, provide basis for clinical medication.Information and Methods1. Sixty cases (60 eyes) age-related cataract patients in our hospital, eliminating retinal detachment, vitreous opacity and other oculer diseases with B ultrasound preoperatively, and ask for glaucoma and uveitis family medical history.2. The patients with phacoemulsification or small incision extracapsular cataract extraction combined IOL implantation were divided into group A, B and C randomly before surgery. During the surgery, group A (20 eyes) were injected o.lmg/0.2ml TA into the anterior chamber, Group B (20 eyes) were injected 0.2mg/0.2ml TA into the anterior chamber. To prevent infection postoperative group A and B were administeraned tobramycin 0.3% 4 times per day for three weeks. Group C were administeraned tobramycin 0.3% and dexamethasone 0.1% 4 times per day for three weeks. They were followed up for 1 month.3. To evaluate the efficacy of intracameral TA, anterior chamber cells, aqueous flare were measured on postoperative days 1,2,7,15 and 30 by slit-lamp biomicroscopy. The safety of intracameral TA was evaluated on postoperative days 1, 2,1,15 and 30 by visual acuity measurements, intraocular pressure values (include 6-8 hours) and fundus examination. Tolerance variables were assessed by the degree of burning, stinging and blurred vision.4. SPSS12.0 package was adopted to carry out statistical analysis' data of anterior chamber cells, aqueous flare, visual acuity and postoperative patients' feel using chi-square test, intraocular pressure data using variance analysis, a=0.05 was taken as the significance test.Results1. The anterior chamber cells and flare in the three groups checkd by slit lamp after surgery, respectively. X2=0.703 P=1, X2=1.276 P=1. There were no statistically significant differences in the amout of anterior chamber cells, flare.2. There were three cases of the intraocular pressure (IOP) more than 30mmHg 6h postoperative in group A, slightly above nomal after 1d and back to nomal after 2d. There were five cases of the IOP more than 30mmHg 6h postoperative, but back to nomal after 2d. There were no obvious rising in group C postoperative 6h. There were no statistically significant differences in the three groups at all time-point assessed (P > 0.05).3. There were no statistically significant differences in the visual acuity and patients' feel after surgery in the three groups (P> 0.05). There were three cases the TA solids deposited before IOL in group C, affecting the visual acuity postoperative 1d and 2d slightly.ConclusionsIntracameral TA 0.1mg/0.2ml,0.2mg/0.2ml can effectively be used to control postoperative inflammation after age-related cataract surgery. This makes it possible to decrease the dosage and duration of topical rednisolone acetate.