Ocular complications after a sub-tenon injection of triamcinolone acetonide for uveitis

The purpose of this study was to evaluate the complications of a sub-Tenon injection of triamcinolone acetonide in patients with uveitis.

We retrospectively reviewed the records of uveitis cases treated from 1999 to 2003 in Kaohsiung Chang Gung Memorial Hospital. Thirty patients (45 eyes), who received a sub-Tenon injection of 0.5 ml of a triamcinolone acetonide suspension for uveitis control, were included, and 16 (26 eyes) of these patients underwent intraocular pressure (IOP) monitoring for over 3 months after the procedure.

The incidence of ocular penetration was 1.6% and of rapidly progressive cataracts was 13.3%. The incidence of ocular hypertension (>21 mmHg) was 76.9% (20/26). The ocular hypertension in most cases was controlled with topical medications, with recovery of normal IOP. Long-term topical antiglaucoma medication was given for 3 eyes, and another 3 eyes (11.5%) received a trabeculectomy performed by glaucoma specialists. The incidence of glaucoma during the follow-up period after treatment is 23.1% (6/26).

The 23.1% incidence of glaucoma in this study is higher than expected. Careful pretreatment evaluation and post-treatment monitoring of IOP are mandatory for patients with uveitis receiving a sub-Tenon injection of triamcinolone acetonide.