Modulation of Intraocular Pressure Following Short-Term Periocular Triamcinolone 0.025% in Oculoplastic Surgery

Corticosteroid use is commonly associated with an increase in intraocular pressure (IOP). Our retrospective study aims to evaluate the effect of short-term periocular topical triamcinolone acetonide (TA) use on IOP.

A retrospective review was conducted of patients treated with periocular 0.025% triamcinolone cream between 2023 and 2024 at a single specialty practice. Patients with baseline and follow-up IOP assessments at their visits were included. Factors such as age, dosage, procedure type, application site, and concomitant TA and 5-fluorouracil (5-FU) subcutaneous injections or neomycin-polymyxin B-dexamethasone drops were analyzed.

A total of 62 patients involving 120 eyes met the inclusion criteria. The overall mean change in IOP (14.35 to 14.32 mm Hg) was not statistically significant ( t = 0.085, p = 0.93). IOP did not significantly increase with age ( r = 0.16, p = 0.21), once daily ( B = -3.3, p = 0.13), or twice daily dosing ( B = -3.5, p = 0.26), nor with concomitant TA and 5-FU injection ( B = -1.5, p = 0.40) or topical steroid drops ( B = -1.5, p = 0.26). Procedure type was not associated with significant IOP changes, specifically upper eyelid blepharoplasty ( B = 0.76, p = 0.39), CO 2 laser resurfacing ( B = 1.2, p = 0.39), and lower eyelid blepharoplasty ( B = 1.9, p = 0.14). Application of TA to the bilateral upper eyelids caused a significant increase in IOP of 1.7 mm Hg ( t = 3.7, p = 0.003), but the maximum IOP was within the normal range (16 mm Hg).

Periocular application of TA cream is not associated with clinically significant changes in IOP when used for limited periods of time.