Frequency of Cataract Surgery after Intravitreal Injection of High-Dosage Triamcinolone Acetonide

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Abstract
Purpose: To evaluate the frequency of cataract surgery after intravitreal injection of high-dosage triamcinolone acetonide in elderly patients. Methods: This clinical interventional case series study included 144 phakic eyes that consecutively received an intravitreal injection of about 20 mg triamcinolone acetonide for diffuse diabetic macular edema (n=42 eyes), exudative age-related macular degeneration (n=98), and branch retinal vein occlusion (n=4). Mean age was 72.3±8.9 years. Mean follow-up was 11.0±6.8 months (median, 8.8 months; range, 3 to 35.5 months). Reinjections were carried out in 12 (8.3%) eyes. Results: Cataract surgery was performed in 20 (13.9%) eyes 17.4±9.1 months (median, 12.7 months; range, 8.0 to 35.5 months) after the first intravitreal injection. Out of the 20 eyes undergoing cataract surgery, 19 (95%) eyes had received one intravitreal injection, and 1 (5%) eye had received two previous injections. Conclusions: In the elderly population of patients with exudative age-related macular degeneration, diffuse diabetic macular edema, or branch retinal vein occlusion, intravitreal high-dosage injection of triamcinolone acetonide leads to clinically significant cataract with eventual cataract surgery in about 15% to 20% of eyes within about 1 year after the intravitreal injection.