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Effects of intravitreal triamcinolone acetonide injection with and without preservative
  1. Mauricio Maia,
  2. Michel Eid Farah,
  3. Rubens N Belfort,
  4. Fernando Marcondes Penha,
  5. Acácio A S Lima Filho,
  6. Fabio Bom Aggio,
  7. Rubens Belfort, Jr
  1. Federal University of São Paulo, Department of Ophthalmology, Vision Institute, São Paulo, Brazil
  1. Mauricio Maia, MD, Vision Institute, Rua Botucatu 822, São Paulo - SP 04023-062, Brazil; maiaretina{at}


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-randomised eyes. No supernatant removal from KE was performed. Non-infectious endophthalmitis was defined as pseudohypopyon/hypopyon with or without an inflammatory reaction that regressed after steroid eye drop instillation. Ocular hypertension was defined as more than 23 mm Hg with Goldman applanation tonometry. Patients were followed and examined 1, 7 and 28 days, and 3, 4, 6 and 12 months after injection and annually thereafter. Statistical analysis was performed using Fisher’s exact test and Χ2 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, SD 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. Non-infectious endophthalmitis developed in 12 eyes (1.9%) and varied significantly in both groups (p = 0.005). One eye developed bacterial endophthalmitis (0.15%).

Conclusions: Non-infectious endophthalmitis was observed significantly more often after KE injections (7.3%) than after PFTA injections (1.2%) (p<0.05). An inflammatory reaction was more clinically relevant in the KE group than in the PFTA group.

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  • Funding: Supported in part by the Foundation for Science Support from Sao Paulo (FAPESP).

  • Competing interests: The authors have no proprietary interest in any aspect of this report.

  • Abbreviations:

    intraocular pressure


    triamcinolone acetonide containing preservative


    preservative-free triamcinolone acetonide


    triamcinolone acetonide

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