Use of triamcinolone in cataract surgery complicated by vitreous loss; effect on visual outcomes and development of cystoid macular oedema

Poster Details

First Author: L.Lawuyi UK

Co Author(s):    A. Ionides   M. Bhogal           

Abstract Details

Purpose:

Posterior capsule rupture with vitreous loss is the commonest intraopertaive complication of phacoemulsification (4%). Triamcinolone has been used to aid visualization and removal of prolapsed vitreous from the anterior chamber. Improved vitreous clearance and the intrinsic anti-inflammatory effect of triamcinolone could theoretically help prevent cystoid macular oedema (CMO) and may improve visual outcome. We examined the outcomes of patients who had posterior capsular ruptures and vitreous loss. We examined whether use of intra-operative triamcinolone had an effect on the subsequent development of CMO and final visual outcome.

Setting:

Moorfields Eye Hospital, London UK (Across all operating sites)

Methods:

A retrospective study of cases of phacoemulsification cataract surgery with vitreous loss was conducted (January 2009 to April 2011). Notes from 206 cases were reviewed for triamcinolone use, patient demographics, pre and post-operative visual acuity, level of surgeon operating and the development of cystoid macular oedema.

Results:

Triamcinolone was used in 83/206 cases. Pre-op visual acuity (logMAR) was 0.68 (6/30 snellen acuity) in the triamcinolone group and 0.64 (6/24) in the non-triamcinolone group (p=0.69). There was no statistically significant difference between patient demographics in each group. Post-op visual acuity was 0.36 (6/15) in the triamcinolone group and 0.31 (6/12) in the non-triamcinolone group (p=0.46). 5/83 patients in the triamcinolone grouped developed CMO. 9/123 patients in the non-triamcinolone group developed CMO (p=0.79). There was no statistically significant difference in use of triamcinolone in consultant versus trainee surgeons (p=0.29).

Conclusions:

Triamcinolone can be used to help visualize vitreous during anterior vitrectomy. It appears equally popular amongst consultant and trainee surgeons. 6.3% of patients developed CMO following cataract surgery complicated by capsular rupture and vitreous loss. Use of triamcinolone does not have a statistically significant effect on final post-operative visual acuity or the chance of developing CMO. FINANCIAL DISCLOSURE?: No