ESCRS - PP24.13 - Comparison Of Outcomes Of Pediatric Cataract Surgery Using Intracameral Triamcinolone Versus Intracameral Dexamethasone- A Single Centre, Prospective, Contralateral Eye Study

Comparison Of Outcomes Of Pediatric Cataract Surgery Using Intracameral Triamcinolone Versus Intracameral Dexamethasone- A Single Centre, Prospective, Contralateral Eye Study

Published 2022 - 40th Congress of the ESCRS

Reference: PP24.13 | Type: Free paper | DOI: 10.82333/ekmb-4p46

Authors: Srishti Agarwal* 1 , Parul Chawla Gupta 1 , Jagat Ram 1 , Jaspreet Sukhija 1 , Savleen Kaur 1 , Sanjay Verma 2

1OPHTHALMOLOGY,ADVANCED EYE CENTRE, PGIMER, CHANDIGARH, INDIA,Chandigarh,India, 2Pediatrics,ADVANCED PEDIATRIC CENTRE, PGIMER,Chandigarh,India

Purpose

To compare the clinical outcomes of pediatric cataract surgery using intracameral triamcinolone and intracameral dexamethasone in contralateral eyes of patients having bilateral congenital or developmental cataract

Setting

Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Methods

In this prospective, comparative study, 48 eyes of 24 children (mean age-1.67± 1.49 years) were included. Intracameral triamcinolone (1.2mg/0.03ml) (n=24 eyes) and dexamethasone (0.4mg/0.1ml) (n=24 eyes) were injected in contralateral eyes of patients at the end of surgery. Number of eyes requiring re-surgeries due to posterior synechiae, pigment deposits on intraocular lens (IOL) or visual axis obscuration (VAO) in each group at the end of three months were analysed as the primary outcome measure. Fixation preferences using CSM (central, steady, maintained) method, intraocular pressure (IOP), anterior segment inflammation, central corneal thickness (CCT) and specular microscopy were also assessed at the end of three months post-operatively

Results

At three months post operatively, 1 eye in triamcinolone group (Group A) and 3 eyes in dexamethasone group (Group B) required re-surgery (p= 0.296). 11 eyes in group A and 13 eyes in group B had CSM fixation (p=0.968) at three months. Both groups had similar cellular reaction at one month (p= 0.987). None of the eyes had cellular reaction at three months. The incidence of posterior synechiae (p= 0.683), pigment deposits on IOL (p= 0.182) and VAO (p=0.551) was similar in both groups. The mean IOP and CCT did not change significantly postoperatively in both groups (Group A p= 0.358, p=0.229; Group B p= 0.625, p=0.669). Specular microscopy (n=4) showed significant decrease in mean endothelial cell count in group A at three months (p=0.012)

Conclusions

Intracameral dexamethasone is as effective as intracameral triamcinolone in decreasing postoperative anterior segment inflammation in pediatric cataract surgery, thereby reducing the number of surgical interventions required, without causing an adverse effect on corneal endothelium