Outcomes Of Congenital Cataract Surgery With Intra-operative Intra-cameral Triamcinolone Injection Versus Postoperative Oral Prednisolone | 44717
Journal of Clinical & Experimental Ophthalmology
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Congenital cataract is an important cause of reversible blindness in childhood. Early diagnosis and surgery, adequate
refractive error correction and aggressive amblyopia management improve these patients visual prognosis. However, early
cataract surgery is associated with greater risk of complications, possibly due to the enhanced inflammatory response and
the more reactive vitreous face in children. The use of corticosteroids for modulating postoperative ocular inflammation was
established decades ago. Topical and systemic corticosteroid administration results in effective intraocular concentrations.
However, they do not maintain long adequate concentrations of the drug in the aqueous humor, which is compensated by
frequent doses in the postoperative period. This, in turn, increases the risk of adverse events. Moreover, caregivers do not always
adhere to the instructions for administering drugs postoperatively, a scenario favoring complications that may compromise
the visual prognosis. In contrast, intraocular injection of corticosteroid delivers an adequate and sustained quantity of the
drug to the target tissue. Triamcinolone acetonide is a deposit corticosteroid with low water solubility, which contributes
to its prolonged action. It has been increasingly used in ophthalmology as a vitreous dye in children and adults, as well as
to modulate intraocular inflammation after phacoemulsification in adults. However, its use is not exempt of risks. Thus, we
conducted a series of studies to investigate and compare the use of intracameral triamcinolone at the end of the procedure
versus the conventional use of postoperative oral prednisolone for modulating intraocular inflammation in children that
undergo congenital cataract surgery younger than 2 years of age.
Marcelo C Ventura was graduated from the Medical School of the University of Pernambuco, in Recife, Brazil and completed his Residency training at the Santa Casa de Misericórdiain São Paulo, Brazil. He has completed his Fellowship training in Retina and Cataract Surgery at the University of Puerto Rico. He has also obtained his Master and PhD degrees at the Federal University of Sao Paulo. He is the Co-Founder and CEO of the Altino Ventura Foundation and Co-Founder and Member of the Board of Directors of the HOPE Hospital, both in Recife, Brazil. He was also the past President of the Latin American Society of Cataract and Refractive Surgeons and of the Brazilian Cataract Society.