[Is subconjunctival steroid administration in addition to local therapy after cataract operations necessary? A laser tyndallometric study].
Subconjunctival steroids are often injected at the end of cataract surgery. In the present laser flare-cell meter study, we investigated whether this procedure improves the anti-inflammatory effect of steroid eye drops.


METHODS
Thirty patients (69-81 years of age) without preexisting deficiencies of the blood-aqueous barrier were investigated preoperatively and after ECCE with PC-IOL implantation. The laser flare-cell meter (model FC 1000; Kowa Company) used for examination permits sensitive and exact determination of aqueous flare. The patients were randomly assigned to one of the following two treatment groups: group A: topical therapy with prednisolone 1% eye drops (Inflanefran forte) 5 times per day; group B: subconjunctival injection of 4 mg dexamethasone (Fortecortin) immediately at the end of surgery; topical therapy as in group A. In addition, all patients received antibiotic therapy using gentamicin eye drops. Oral steroids were not administered.


RESULTS
Under topical therapy with prednisolone 1% (group A), the aqueous flare (in photon counts/millisecond) increased from a preoperative value of 10.2 +/- 2.5 (mean +/- SD) to 37.3 +/- 11.1 in the afternoon after surgery (8 h postoperatively) and decreased to 30.9 +/- 38.7 and 27.8 +/- 3.2 on days 1 and 3 after surgery. With additional steroid injection (group B), the flare accounted to 31.7 +/- 8.7 in the afternoon after surgery and to 31.3 +/- 5.9 and 27.1 +/- 4.7 on days 1 and 3 after surgery, respectively. There was no significant group difference (P > 0.3).


CONCLUSIONS
After uncomplicated cataract surgery, subconjunctival steroid injection (4 mg dexamethasone) does not improve the effect of potent anti-inflammatory topical therapy (prednisolone 1% eye drops).
Schmitt
K
K
Universitäts-Augenklinik Giessen.
Hessemer
V
V
D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction / Q000379:methods*; D003228:Conjunctiva; D003907:Dexamethasone / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D009877:Endophthalmitis / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007267:Injections; D007910:Lenses, Intraocular; D008297:Male; D009883:Ophthalmic Solutions; D011183:Postoperative Complications / Q000517:prevention & control*; D011239:Prednisolone / Q000008:administration & dosage* / Q000009:adverse effects
D009883:Ophthalmic Solutions; D003907:Dexamethasone; D011239:Prednisolone
Ist eine subkonjunktivale Steroidgabe zusätzlich zur Lokaltherapie nach Kataraktoperationen notwendig? Eine lasertyndallometrische Untersuchung.