Macular And Intraocular Pressure Outcomes After Dropless Cataract Surgery Using Subconjunctival Triamcinolone
Published 2026 - 44th Congress of the ESCRS
Reference: POCAT147 | Type: Free paper | DOI: 10.82333/3ycb-9g52
Authors: Dr Yaakov Caspi* 1 , Dr Joel Hanhart 1 , A/Prof. Adi Abulafia 1 , Dr Igor Mintser 1 , A/Prof. David Zadok 1
1Department of Ophthalmology,Shaare Zedek Medical Center, Faculty of Medicine, The Hebrew University,Jerusalem,Israel
Purpose
To evaluate macular optical coherence tomography (OCT) outcomes following uncomplicated cataract surgery using a dropless steroid protocol with intraoperative subconjunctival triamcinolone, and to assess its effect on intraocular pressure (IOP).
Setting
Department of Ophthalmology, Shaare Zedek Medical Center, Faculty of Medicine, The Hebrew University, Jerusalem, Israel
Methods
In this Retrospective observational cohort study consecutive adults who underwent uncomplicated phacoemulsification were included. All patients received a dropless protocol consisting of a 4 mg intraoperative subconjunctival triamcinolone depot injection and ofloxacin eye drops. Patients with diabetes additionally received topical bromfenac eye drops postoperatively. Macular OCT was performed preoperatively and at final follow-up (3–5 weeks postoperatively). Outcomes included changes in central subfield thickness (CST), the proportion of eyes with a >10% CST increase, incidence of OCT-defined cystoid macular edema (CME), and changes in IOP from baseline to final follow-up. Subgroup analysis excluded patients with diabetes.
Results
Forty-six eyes were analyzed. Mean CST increased from 272±29.37 µm preoperatively to 288.13±65.05 µm postoperatively (p = 0.05). Excluding diabetic patients, the increase was not significant (272.37±24.11 vs. 288.59±52.60 µm; p = 0.07). A >10% CST rise occurred in 11% overall and 12% of non-diabetic patients (p = 0.804 and in p = 0.556 respectively). Intraretinal cysts were detected in 7.1% preoperatively and 11.9% postoperatively (p = 0.5). In non-diabetics, the corresponding rates were 0% and 7.14%, respectively (p = 0.5). Mean IOP remained stable, measuring 15.15±2.74 mmHg preoperatively and 14.63±3.10 mmHg postoperatively in the overall cohort (p = 0.25), and 15.29±2.76 versus 14.70±3.08 mmHg in non-diabetic patients (p = 0.28).
Conclusions
Dropless cataract surgery with intraoperative subconjunctival triamcinolone was associated with stable intraocular pressure and no statistically significant increase in macular thickness among non-diabetic patients, supporting its use as a potential alternative to postoperative topical steroid therapy.