Congenital cataract surgery with intracameral triamcinolone: Pre- and postoperative central corneal thickness and intraocular pressure

Ventura, Marcelo Carvalho; Ventura, Bruna Vieira; Ventura, Camila V.; Ventura, Liana; Nosé, Walton

doi:10.1016/j.jaapos.2012.06.005

Cited by 11 publications

(4 citation statements)

References 28 publications

(41 reference statements)

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“…Subconjunctival and posterior sub-Tenon injections may cause subconjunctival hemorrhage and chemosis [10,11], in addition to hazard of general anesthesia. Intracameral injection of steroids into the anterior chamber immediately after surgery avoids these possible disadvantages and provides higher concentrations of the drug at the target tissue [12].…”

Section: Discussionmentioning

confidence: 99%

Pediatric Cataract Surgery and Intraocular Lens Implantation with and without Intracameral Triamcinolone Acetonide

Solaiman¹,

Maaly²,

Albialy³

et al. 2016

J Clin Exp Ophthalmol

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Purpose: To evaluate the safety and efficacy of a single intracameral injection of triamcinolone acetonide in controlling postoperative ocular inflammation and improving the outcome of pediatric cataract surgery with intraocular lens implantation.Setting: Prospective interventional comparative Quasi study. Patients and methods:The study was performed on eyes of children between 6-12 years old having significant cataract and subjected to cataract extraction with primary IOL implantation. Patients were divided into two almost equal age and sex matched groups. The study group included eyes that received intracameral injection of 4 mg/0.13 ml of preservative-free triamcinolone acetonide at the end of surgery while the control group included eyes that did not receive intracameral injection of triamcinolone acetonide. Postoperative examinations were done on day 1 then weekly for 1 month, and monthly for another 2 months. Primary outcome measures included any sign of anterior segment inflammation, while secondary outcome measures included best corrected visual acuity, intraocular pressure and any reported complication caused by intracameral triamcinolone acetonide. Results:The study included 42 eyes (35 patients); 21 eyes in each group. Postoperative inflammatory membrane was statistically significant higher in the control group than in the study group (P=0.018). The mean duration of using topical steroids in the study group (17.2 ± 4.1 days) was statistically significant less than its mean duration (28.3 ± 3.4 days) in the control group (P<0.05). No statistically significant differences were detected between pre and postoperative intraocular pressure in each group and in between both groups. No significant complications related to intracameral triamcinolone acetonide were reported. Conclusion:A single intracameral injection of 4 mg preservative free triamcinolone acetonide at the end of uncomplicated pediatric cataract surgery could be an effective and safe adjunct to postoperative topical steroids in controlling postoperative ocular inflammation.

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Section: Discussionmentioning

confidence: 99%

Pediatric Cataract Surgery and Intraocular Lens Implantation with and without Intracameral Triamcinolone Acetonide

Solaiman¹,

Maaly²,

Albialy³

et al. 2016

J Clin Exp Ophthalmol

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“…1,2 In some developing countries, IOLs are used almost exclusively as the primary optical correction for children following cataract surgery. 3–5 In addition to their convenience, IOL implantation during childhood may be associated with better visual outcomes. 6 However, when IOLs are implanted during early infancy, these potential advantages are offset by a higher incidence of intraoperative and postoperative adverse events.…”

mentioning

confidence: 99%

Comparison of Contact Lens and Intraocular Lens Correction of Monocular Aphakia During Infancy

et al. 2014

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The Infant Aphakia Treatment Study Group IMPORTANCE The efficacy and safety of primary intraocular lens (IOL) implantation during early infancy is unknown.OBJECTIVE To compare the visual outcomes of patients optically corrected with contact lenses vs IOLs following unilateral cataract surgery during early infancy. DESIGN, SETTING, AND PARTICIPANTSThe Infant Aphakia Treatment Study is a randomized clinical trial with 5 years of follow-up that involved 114 infants with unilateral congenital cataracts at 12 sites. A traveling examiner assessed visual acuity at age 4.5 years.INTERVENTIONS Cataract surgery with or without primary IOL implantation. Contact lenses were used to correct aphakia in patients who did not receive IOLs. Treatment was determined through random assignment.MAIN OUTCOMES AND MEASURES HOTV optotype visual acuity at 4.5 years of age. RESULTSThe median logMAR visual acuity was not significantly different between the treated eyes in the 2 treatment groups (both, 0.90 [20/159]; P = .54). About 50% of treated eyes in both groups had visual acuity less than or equal to 20/200. Significantly more patients in the IOL group had at least 1 adverse event after cataract surgery (contact lens, 56%; IOL, 81%; P = .02). The most common adverse events in the IOL group were lens reproliferation into the visual axis, pupillary membranes, and corectopia. Glaucoma/glaucoma suspect occurred in 35% of treated eyes in the contact lens group vs 28% of eyes in the IOL group (P = .55). Since the initial cataract surgery, significantly more patients in the IOL group have had at least 1 additional intraocular surgery (contact lens, 21%; IOL, 72%; P < .001). CONCLUSIONS AND RELEVANCEThere was no significant difference between the median visual acuity of operated eyes in children who underwent primary IOL implantation and those left aphakic. However, there were significantly more adverse events and additional intraoperative procedures in the IOL group. When operating on an infant younger than 7 months of age with a unilateral cataract, we recommend leaving the eye aphakic and focusing the eye with a contact lens. Primary IOL implantation should be reserved for those infants where, in the opinion of the surgeon, the cost and handling of a contact lens would be so burdensome as to result in significant periods of uncorrected aphakia. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00212134

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“…50-52 While existing studies have described the causes of visual impairment of children in South America 47,48 and the need for early diagnosis and treatment for congenital cataracts there, 46,49 few studies have included information about follow-up after congenital cataract surgery in South America. 50-52 In addition, in Peru parents are required to purchase the surgical supplies needed including an IOL when cataract surgery is performed in public hospitals. This is a significant financial burden to the parents of many children with cataracts.…”

Section: Results: Regional Challengesmentioning

confidence: 99%

Global challenges in the management of congenital cataract: proceedings of the 4th International Congenital Cataract Symposium held on March 7, 2014, New York, New York

Lenhart

Courtright

Wilson

et al. 2015

Journal of American Association for Pediatric Ophthalmology and

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Summary Childhood cataracts have become a leading cause of preventable childhood blindness in many areas of the world. Here we summarize regional focus group discussions from the 4th Annual International Congenital Cataract Symposium on the current situation, challenges, and recommendations for the management of congenital cataracts in sub-Saharan Africa, the Middle East and North Africa, South Asia, Central America, South America, and developed nations. Strategies for managing congenital cataracts must be adapted and developed according to regional conditions. A basic framework for acceptable outcomes must focus on developing systems to address the critical components of education, access, quality care, and good follow-up.

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Congenital cataract surgery with intracameral triamcinolone: Pre- and postoperative central corneal thickness and intraocular pressure

Cited by 11 publications

References 28 publications

Pediatric Cataract Surgery and Intraocular Lens Implantation with and without Intracameral Triamcinolone Acetonide

Pediatric Cataract Surgery and Intraocular Lens Implantation with and without Intracameral Triamcinolone Acetonide

Comparison of Contact Lens and Intraocular Lens Correction of Monocular Aphakia During Infancy

Global challenges in the management of congenital cataract: proceedings of the 4th International Congenital Cataract Symposium held on March 7, 2014, New York, New York

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