Comparison of Anti-inflammatory Effect between Intracameral Triamcinolone Acetonide and Topical Dexamethasone after Phacoemulsification

Background: Despite better surgical methods and intraocular lenses, phacoemulsification has emerged as the most widely used and gold standard in cataract surgery today. One of the most typical surgical consequences is postoperative inflammation. Surgical trauma damages the blood aqueous barrier, allowing proteins and inflammatory cells to flow into the anterior chamber. Objective: The aim of the current study is to compare the effectiveness of a single intracameral dose of triamcinolone and topical dexamethasone in controlling inflammation following phacoemulsification.
Patients and methods: The current clinical trial included 60 eyes divided into two equal groups; Group A included 30 eyes which received single intracameral injection of triamcinolone acetonide (ICTA) 1 mg at the end of surgery, and Group B included 30 eyes which was given topical dexamethasone eye drops 5 times per day for 1 week and the dose decreased gradually. Results: It is found that there was no statistically significant difference between the two studied groups regarding corneal edema, anterior chamber (AC) cells at 1 day and 1 week after surgery. All cases of the two groups were found negative for corneal edema, AC cells at 1 month and 3^rd month postoperative. There was no significant difference between the two groups in terms of mean BCVA or intraocular pressure (IOP) at any time point (P >0.05) postoperatively. Our results show that there was highly significant difference between the two studied groups regarding conjunctival irritation at 1 day, 1 week and 1 month and there is non-significant difference at 3^rd month. No significant complications like endophthalmitis were observed.
Conclusion: Intracameral triamcinolone injection was demonstrated to be a promising safe alternative to topical dexamethasonen with comparable efficacy in terms of the management of postoperative inflammation after phacoemulsification and was associated with minimal complications and higher compliance.