Comparison between intravitreal and orbital floor triamcinolone acetonide after phacoemulsification in patients with endogenous uveitis.
OBJECTIVE
To compare the effect of intravitreal and orbital floor triamcinolone acetonide (TA) on macular edema, visual outcome, and course of postoperative inflammation after cataract surgery in uveitis patients.


METHODS
Prospective, randomized clinical trial.


METHODS
Monocenter study (40 patients) with chronic endogenous uveitis who underwent phacoemulsification with intraocular lens implantation with either 4 mg intravitreal TA (n = 20) or 40 mg orbital floor TA (n = 20). The primary outcome was influence on cystoid macular edema (CME). Secondary outcome measures were best-corrected visual acuity (BCVA), anterior chamber cell grade, laser flare photometry, giant cell deposition, posterior capsule opacification (PCO), and intraocular pressure.


RESULTS
Mean central foveal thickness decreased in the intravitreal TA group and increased in the orbital floor TA group (P < .001 at one and three months). CME improved in 50% of patients after intravitreal TA, whereas it was unchanged after orbital floor TA (difference between the groups at three months, P = .049). Mean BCVA (logarithm of the minimal angle of resolution) improved postoperatively (P < .001) from 0.76 and 0.74 to 0.22 and 0.23 in the intravitreal TA and orbital floor TA group, respectively. Anterior chamber cell count at one month was lower in the intravitreal TA than in the orbital floor TA group (P = .02). Laser flare photometry values and giant cell numbers were slightly higher after orbital floor TA than after intravitreal TA. The groups did not differ with respect to PCO rate and ocular hypertension.


CONCLUSIONS
The CME improvement and anti-inflammatory effect after intravitreal TA was better than after orbital floor TA injection in cataract surgery in uveitis patients.
Roesel
Martin
M
Department of Ophthalmology, St Franziskus-Hospital, Muenster, Germany.
Tappeiner
Christoph
C
Heinz
Carsten
C
Koch
Joerg M
JM
Heiligenhaus
Arnd
A
D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D002908:Chronic Disease; D004333:Drug Administration Routes; D005260:Female; D006801:Humans; D007267:Injections; D019654:Lens Implantation, Intraocular; D008269:Macular Edema / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009915:Orbit; D018918:Phacoemulsification; D011182:Postoperative Care; D011446:Prospective Studies; D019591:Pseudophakia / Q000503:physiopathology; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*; D014605:Uveitis / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body
D000893:Anti-Inflammatory Agents; D014222:Triamcinolone Acetonide