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Effects of Intravitreal Triamcinolone Acetonide Injection with and without Preservatives
  1. Mauricio Maia (penhaepm{at}yahoo.com.br),
  2. Michel E Farah (mefarah{at}uol.com.br),
  3. Rubens Belfort Neto, Neto (penhaepm{at}yahoo.com.br),
  4. Fernando M Penha (penhaepm{at}yahoo.com.br),
  5. Fabio B Aggio (penhaepm{at}yahoo.com.br),
  6. Acacio AS Lima, Filho (penhaepm{at}yahoo.com.br),
  7. Rubens Belfort, Jr
  1. Vision Institute (IPEPO) - Departament of Ophthalmology - Federal University of São Paulo, Brazil
  2. Vision Institute (IPEPO) - Departament of Ophthalmology - Federal University of São Paulo, Brazil
  3. Vision Institute (IPEPO) - Departament of Ophthalmology - Federal University of São Paulo, Brazil
  4. Vision Institute (IPEPO) - Departament of Ophthalmology - Federal University of São Paulo, Brazil
  5. Vision Institute (IPEPO) - Departament of Ophthalmology - Federal University of São Paulo, Brazil
  6. Vision Institute (IPEPO) - Departament of Ophthalmology - Federal University of São Paulo, Brazil
  7. Vision Institute (IPEPO) - Departament of Ophthalmology - Federal University of São Paulo, Brazil

    Abstract

    Aims: To evaluate the effects of intravitreal injection of preservative-free triamcinolone acetonide (PFTA) and TA containing preservative (KE).

    Methods: A retrospective review was conducted of 646 intravitreal 4 mg/0.1 ml steroid injections in 471 eyes. A total of 577 intravitreal injections of PFTA and 69 injections of KE were administered in non-randomized eyes. No supernatant removal from KE was performed. Noninfectious endophthalmitis was defined as pseudohypopyon/hypopyon with or without an inflammatory reaction that regressed after steroid eye drop instillation. Ocular hypertesion was defined as more than 23 mmHg with Goldman aplanation tonometry. The patients were followed and examined 1, 7, and 28 days and 3, 4, 6 as well as 12 months after injection and annually thereafter. Statistical analysis was performed using Exact Fisher test and Qui-square test. P-values < 0.05 were considered significant.

    Results: Both groups did not differ in demographics (P>0.05). Follow-up ranged from 6 to 57 months (mean, 13±7.5). Ocular hypertension was present in 127 eyes (20%), but both groups did not differ significantly (P=0.167). Four eyes (3.15%) required trabeculectomy. Noninfectious endophthalmitis developed in twelve eyes (1.9%) and varied significantly in both groups (P=0.005). One eye developed bacterial endophthalmitis (0.15%).

    Conclusions: Noninfectious endophthalmitis was observed significantly more often after KE injections (7.3%) compared with PFTA injections (1.2%) (P<0.05). An inflammatory reaction was more clinically relevant in the KE group than in the PFTA group.

    • benzyl alcohol
    • endophthalmitis
    • intravitreous injection
    • macular edema
    • triamcinolone acetonide

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