Effects of intravitreal triamcinolone acetonide injection with and without preservative.
OBJECTIVE
To evaluate the effects of intravitreal injection of preservative-free triamcinolone acetonide (PFTA) and TA containing preservative (KE).


METHODS
A retrospective review was conducted of 646 intravitreal 4 mg/0.1 ml steroid injections in 471 eyes. A total of 577 intravitreal injections of PFTA and 69 injections of KE were administered in non-randomised eyes. No supernatant removal from KE was performed. Non-infectious endophthalmitis was defined as pseudohypopyon/hypopyon with or without an inflammatory reaction that regressed after steroid eye drop instillation. Ocular hypertension was defined as more than 23 mm Hg with Goldman applanation tonometry. Patients were followed and examined 1, 7 and 28 days, and 3, 4, 6 and 12 months after injection and annually thereafter. Statistical analysis was performed using Fisher's exact test and Chi(2) test. p Values <0.05 were considered significant.


RESULTS
Both groups did not differ in demographics (p>0.05). Follow-up ranged from 6 to 57 months (mean 13, SD 7.5). Ocular hypertension was present in 127 eyes (20%), but both groups did not differ significantly (p = 0.167). Four eyes (3.15%) required trabeculectomy. Non-infectious endophthalmitis developed in 12 eyes (1.9%) and varied significantly in both groups (p = 0.005). One eye developed bacterial endophthalmitis (0.15%).


CONCLUSIONS
Non-infectious endophthalmitis was observed significantly more often after KE injections (7.3%) than after PFTA injections (1.2%) (p<0.05). An inflammatory reaction was more clinically relevant in the KE group than in the PFTA group.
Maia
Mauricio
M
Federal University of São Paulo, Department of Ophthalmology, Vision Institute, São Paulo, Brazil. maiaretina@uol.com.br
Farah
Michel Eid
ME
Belfort
Rubens N
RN
Penha
Fernando Marcondes
FM
Lima Filho
Acácio A S
AA
Aggio
Fabio Bom
FB
Belfort
Rubens
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004341:Drug Evaluation; D009877:Endophthalmitis / Q000139:chemically induced; D005128:Eye Diseases / Q000188:drug therapy*; D015818:Eye Infections, Bacterial / Q000209:etiology; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000139:chemically induced; D009883:Ophthalmic Solutions; D011310:Preservatives, Pharmaceutical / Q000008:administration & dosage / Q000009:adverse effects*; D012189:Retrospective Studies; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D014822:Vitreous Body
D005938:Glucocorticoids; D009883:Ophthalmic Solutions; D011310:Preservatives, Pharmaceutical; D014222:Triamcinolone Acetonide