Steroid Response Following Dropless Cataract Surgery Using Subconjunctival Triamcinolone

Area of Science:

• Ophthalmology
• Surgical Innovation
• Pharmacology

Background:

• Cataract surgery is a common procedure with various postoperative management strategies.
• Steroid response, characterized by elevated intraocular pressure (IOP), is a known complication.
• Dropless cataract surgery aims to simplify postoperative care by using subconjunctival steroid depots.

Purpose of the Study:

• To compare the rates of postoperative steroid response between dropless cataract surgery (subconjunctival triamcinolone) and conventional cataract surgery (topical prednisolone).
• To identify risk factors associated with steroid response after cataract surgery.

Main Methods:

• A retrospective review of consecutive cataract surgery cases (dropless vs. conventional) was conducted.
• Steroid response was defined as a 50% increase in IOP above baseline or IOP > 24 mmHg, excluding the first 72 hours postoperatively.
• Logistic regression models were used to analyze risk factors and outcomes.

Main Results:

• A higher proportion of eyes undergoing dropless surgery developed a steroid response (10% vs. 5%), though not statistically significant (P=0.096).
• Significant risk factors for steroid response included dropless surgery (OR=2.43) and a prior diagnosis of glaucoma (OR=7.18).
• Dropless cases showed a higher incidence of prolonged IOP elevation (≥30 days).

Conclusions:

• Dropless cataract surgery, utilizing subconjunctival triamcinolone, is associated with an increased risk of prolonged postoperative steroid response.
• Patients with a history of glaucoma are at significantly higher risk for steroid response and may not be suitable candidates for this type of dropless surgery.