Document Type : Original Article
Authors
1
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt.
2
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
3
Department of ophthalmology, faculty of medicine,Al-Azhar university, Damietta, Egypt.
Abstract
Background: Phacoemulsification is the gold standard for cataract surgery, offering significant improvements in visual acuity and quality of life. However, corneal endothelial damage during surgery may lead to edema or, in severe cases, corneal decompensation. While intracameral triamcinolone acetonide [TA] has demonstrated anti-inflammatory efficacy, its impact on corneal endothelial cells during cataract surgery is not fully understood. This study aimed to assess the safety and effect of intracameral TA on corneal endothelial parameters during phacoemulsification cataract surgery.
Patients and methods: This prospective interventional study included 40 eyes of 40 patients undergoing cataract surgery at Al-Azhar University Hospital. Patients were divided into two groups: Group 1 underwent phacoemulsification with intracameral TA, and Group 2 underwent phacoemulsification alone. Corneal endothelial parameters, including cell density [CD], central corneal thickness [CCT], coefficient of variation [CV], and hexagonality [HEX], were measured preoperatively and postoperatively [1 and 3 months]. Data analysis included visual acuity, corneal edema, intraocular pressure [IOP], and complications.
Results: Both groups showed significant postoperative improvement in BCVA [p<0.001]. Endothelial cell density decreased similarly in both groups at 3 months [p=0.7], with no significant changes in HEX or CV between groups. Group 1 demonstrated reduced corneal edema at 1 month compared to Group 2. Complications were observed in three cases in Group 1, including transient IOP elevation, Descemet membrane detachment, and IOL opacification. TA precipitations resolved without adverse effects.
Conclusion: Intracameral TA is a safe and effective adjunct to cataract surgery, offering anti-inflammatory benefits without significantly impacting corneal endothelial parameters. Its use may reduce postoperative corneal edema and improve surgical outcomes.
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