Posters

Triamcinolone acetonide in paediatric cataract surgery without posterior capsulorhexis

Poster Details

First Author: J.Abreu SPAIN

Co Author(s):    C. Pinto   V. Lozano   P. Ruiz   J. Agustino   J. Aguilar  

Abstract Details

Purpose:

To show the intracameral triamcinolone acetonide (TA) without preservative usefulness in pediatric cataract surgery (PC) with posterior chamber intraocular lens (IOL) implantation and no capsulorhexis (CCC).

Setting:

Ophthalmology Service. University Hospital of the Canary Islands. Tenerife, Spain.

Methods:

Case report of a 12 year-old man referred to our department in March 2013 for surgical treatment of bilateral cataracts . Lamellar cataract was diagnosed in both eyes (BE ) since he was 5 years old with bilateral progression. Best corrected visual acuity was 0.4 in the right eye (RE) and 0.3 in the left eye (LE) , which difficult his school activity. No concomitant health problems neither previous ophthalmological history were reported.

Results:

Left eye surgical treatment was performed following the usual protocol of our pediatric cataract department for PC surgery for this age group: general anesthesia, clear cornea incisions, diathermy cystotome CCC (Dukap II , Oertli Instrument AG , Switzerland), high vacuum cataract extraction using bimanual cannulas, not performing posterior CCC, and anterior vitrectomy. Then we injected intracameral TA and a monoblock foldable hydrophobic acrylic IOL in the capsular bag was implanted, ending with the viscoelastic extraction. Incisions were sutured with naylon 10-0 , and 1mg/0.1 mL of intracameral cefuroxime injection (ProkamR Laboratoires Thea , Clermont- Ferrand , France) was performed. Right eye cataract surgery was performed one week later with the same surgical protocol. Immediate postoperative period had almost no inflammation in both eyes. One month post-op left eye lit -lamp examination showed no posterior capsule opacification, which persists at 6 months. Right eye had the same postoperative evolution. We observed no postoperative endophthalmitis - sterile or infectious - , ocular hypertension or glaucoma, and no damage with more than 6 months follow-up.

Conclusions:

Intracameral TA usage might be a good tool for PC surgery with IOL implantation in patients older than 8 years in who no subsequent CCC is performed. Due to its significance in preventing early postoperative swelling and visual axis lost of transparency and its unknowed security profile more research is needed. FINANCIAL INTEREST: NONE