Inflammation Control Without Endothelial Cost: Evaluating Intracameral Triamcinolone In Cataract Surgery

Phacoemulsification is the gold standard for cataract surgery, offering significant improvements in visual acuity and quality of life. However, corneal endothelial damage during surgery may lead to edema or, in severe cases, corneal decompensation. While intracameral triamcinolone acetonide (TA) has demonstrated anti-inflammatory efficacy, its impact on corneal endothelial cells during cataract surgery is not fully understood. This study aimed to assess the safety and efficacy of intracameral TA on corneal endothelial parameters during phacoemulsification cataract surgery.

Al-Azhar University Hospital - Damietta

This prospective interventional study included 40 eyes of 40 patients undergoing cataract surgery at Al-Azhar University Hospital. Patients were divided into two groups: Group 1 underwent phacoemulsification with intracameral TA, and Group 2 underwent phacoemulsification alone. Corneal endothelial parameters, including cell density (CD), central corneal thickness (CCT), coefficient of variation (CV), and hexagonality (HEX), were measured preoperatively and postoperatively (1 and 3 months). Data analysis included visual acuity, corneal edema, intraocular pressure (IOP), and complications

Both groups showed significant postoperative improvement in BCVA (p<0.001). Preoperative mean CD was 2823 ± 420.4 cells/mm² in Group 1 and 2736 ± 444.9 cells/mm² in Group 2 (p = 0.5). At 1 month, CD decreased to 2535 ± 467.4 in Group 1 and 2507 ± 440.8 in Group 2 (p = 0.8), and at 3 months, to 2519 ± 481.2 and 2476 ± 432 cells/mm², respectively (p = 0.7). There were no significant changes in HEX or CV between groups. Complications were observed in three cases in Group 1, including transient IOP elevation, Descemet membrane detachment, and IOL opacification. TA precipitations resolved without adverse effects

Intracameral TA is a safe and effective adjunct to cataract surgery, offering anti-inflammatory benefits without significantly impacting corneal endothelial parameters. Its use may reduce postoperative corneal edema and improve surgical outcomes