Transient anterior chamber intraocular lens opacification by triamcinolone acetonide following intravitreal injection

Pseudophakic cystoid macular edema (CME) following primary anterior-chamber intraocular lens (ACIOL) implantations is commonly seen. Intravitreal triamcinolone acetonide (IVTA) injections have shown significant improvement in visual acuity and retinal thickness in refractory pseudophakic CME. Pseudohypopyon following IVTA injection is a known entity.

To report a rare complication of transient acute vision loss due to ACIOL coating with triamcinolone acetonide particles following intravitreal injection.

Case study.

A patient developed pseudophakic cystoid macular edema two months post complicated cataract operation with ACIOL implantation. Despite topical steroid treatment, CME persisted and the patient was administered intravitreal triamcinolone acetonide injection. Acute vision loss due to dense coating of ACIOL with triamcinolone particles was noted on the next day. Conservative management led to spontaneous clearing of intraocular lens (IOL) and resolution of CME in 4 weeks.

Opacification of ACIOL following IVTA injection is a rare complication which can be seen in eyes with compromised zonular/capsular bag integrity.