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4. Perioperative subconjunctival triamcinolone acetonide injection for prevention of inflammation and macular oedema after cataract surgery.

Author

Lindholm, Juha‐Matti, Taipale, Claudia, Ylinen, Petteri, and Tuuminen, Raimo

Subjects
CATARACT surgery, TRIAMCINOLONE acetonide, INTRAOCULAR pressure, PHACOEMULSIFICATION, ELECTIVE surgery, EDEMA
Abstract

Purpose: To compare the efficacy, safety and tolerability of a single perioperative subconjunctival injection of triamcinolone acetonide (TA) with steroid drops for the prevention of macular oedema and ocular inflammation after cataract surgery. Methods: This prospective non‐randomized controlled clinical trial analysed 101 eyes of 101 patients having an elective cataract surgery at Kymenlaakso Central Hospital, Kotka, Finland. Fifty eyes received conventional postoperative care with dexamethasone 1 mg/ml eye drops (DEX), and 51 eyes received a perioperative 20 mg subconjunctival injection of TA. None of the eyes received postoperative topical antibiotic prophylaxis. The main outcome measures were aqueous flare, central retinal thickness (CRT), corrected distance visual acuity (CDVA) and intraocular pressure (IOP) measured at 7, 28 and 90 days after surgery. Results: Central retinal thickness (CRT) increased in DEX but not in TA‐treated eyes at 7 days (+1.2 ± 20.1 μm and −9.2 ± 24.8 μm, p = 0.031), at 28 days (+23.8 ± 62.6 μm and −3.3 ± 27.7 μm, p = 0.008) and at 90 days (+8.5 ± 24.4 μm and −5.5 ± 33.4 μm, p = 0.026). Aqueous flare increased from baseline in both groups but remained higher in DEX eyes at 90 days (+3.3 ± 9.9 photons/ms and −0.2 ± 6.6 photons/ms, p = 0.021). Corrected distance visual acuity (CDVA) and IOP changes were similar, and ocular tolerance was good in both groups. No serious adverse events were observed. Conclusions: Perioperative subconjunctival TA was effective in preventing ocular inflammation and macular oedema after cataract surgery. Subconjunctival TA combined with intracameral cefuroxime provides a noteworthy option for dropless postoperative care in modern cataract surgery. [ABSTRACT FROM AUTHOR]

Published
2020
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9. Intravitreal bevacizumab injections versus dexamethasone implant for treatment-naïve retinal vein occlusion related macular edema

Author

Laine,Ilkka, Lindholm,Juha-Matti, Ylinen,Petteri, Tuuminen,Raimo, Laine,Ilkka, Lindholm,Juha-Matti, Ylinen,Petteri, and Tuuminen,Raimo

Abstract

Ilkka Laine,1–3 Juha-Matti Lindholm,1,2 Petteri Ylinen,1,4 Raimo Tuuminen1,2,5 1Helsinki Retina Research Group, University of Helsinki, Helsinki, 2Unit of Ophthalmology, Kymenlaakso Central Hospital, Kotka, Finland; 3Department of Automation and Electrical Engineering, Aalto University, Helsinki, Finland; 4Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland; 5The Insurance Centre, Patient Insurance Centre, Helsinki, Finland Purpose: To compare the short-term effects of three monthly intravitreal bevacizumab (IVB) injections to single dexamethasone (DEX) implantation in treatment-naïve patients with cystoid macular edema (CME) secondary to branch (BRVO) and central retinal vein occlusion (CRVO).Design: A retrospective single-center study.Subjects: A total of 135 eyes of 135 patients with BRVO (n=83) and CRVO (n=52).Methods: Changes in clinical parameters were recorded before treatment and at the first and third month after commencement of IVB (n=121) and DEX (n=14).Main outcome measures: Central retinal thickness (CRT), intraocular pressure (IOP), and best-corrected visual acuity (BCVA).Results: The baseline parameters were comparable between IVB and DEX groups. After the first month, CRT decreased by 131.3±42.9 µm in IVB and by 266.9±48.3 µm in DEX (mean ± SEM; p=0.047). IOP change was –0.29±0.39 mmHg in IVB and +3.70±2.34 mmHg in DEX (p=0.005). IOP elevation to ≥25 mmHg and ≥5 mmHg from the baseline was observed in two of the DEX- and in none of the IVB-treated eyes (p=0.010). After the third month, no differences regarding CRT and IOP were observed between the treatment modalities. Moreover, BCVA gain was comparable between IVB (0.37±0.05 logarithm of minimum angle of resolution [logMAR] units) and DEX (0.33±0.30 logMAR units) groups.Conclusion: DEX was associated with faster resolution of CME, but had

Published
2017

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