Sterile endophthalmitis following intravitreal injection of preservative-free triamcinolone acetonide.
OBJECTIVE
To describe two cases of sterile endophthalmitis following intravitreal injection of preservative-free triamcinolone acetonide.


METHODS
Chart review.


RESULTS
Two patients with histories of sterile inflammatory reaction to intravitreal Kenalog (triamcinolone acetonide) subsequently were treated with intravitreal injections of preservative-free triamcinolone. Both patients presented 2 to 3 days after injection with significant anterior chamber cell reaction without pain or inflammation-related conjunctival injection. The intraocular inflammation of both patients resolved completely using only topical steroids and antibiotics.


CONCLUSIONS
An inflammatory reaction to the vehicle has been the leading hypothesis for the etiology of the sterile inflammatory response following intravitreal Kenalog injections. The use of preservative-free triamcinolone is intended to eliminate this potential source of toxicity. These cases demonstrate that noninfectious endophthalmitis can develop even with preservative-free triamcinolone.
From The Retina Service of Wills Eye Institute, Thomas Jefferson University, Philadelphia, Pennsylvania.
Andrew
A
Lam
Sunir J
SJ
Garg
Marc J
MJ
Spirn
Mitchell S
MS
Fineman
Arunan
A
Sivalingam