Incidence of scleritis requiring surgical repair from subconjunctival triamcinolone acetonide injections in patients with scleritis in TriNetX

Abstract Purpose To estimate the yearly and 15-year cumulative incidence of scleritis requiring surgical repair in patients with a prior diagnosis of scleritis who received a subconjunctival or subTenon triamcinolone acetonide injection (STAI). Design A retrospective cohort study was conducted using the TriNetX US Collaborative Network. TriNetX is an electronic health records database with anonymized, deidentified encrypted data from 69 healthcare networks. Methods Subjects with a history of scleritis were identified using ICD-10 (International Classification of Diseases, 10th Revision) code H15.0X and who subsequently underwent a STAI as identified using the CPT (current procedural terminology) code between January 1, 2009 to December 31, 2024. CPT codes were used to identify STAIs include subconjunctival injection (68200) or subTenon injection (67515) and injection of triamcinolone acetonide 10 mg (J3301). Please note that H15.0X codes specifying posterior scleritis were excluded from this cohort in an attempt to localize anterior scleritis. The time relation was set to ensure all patients in the cohort had an existing diagnosis of scleritis prior to any instance of STAI. The primary outcome measure was the annual and 15-year cumulative incidence of required surgical repair within 4 weeks, and 3, 6, 9, and 12 m after the STAI as best estimated by scleral graft reinforcement and repair of scleral staphyloma with graft, CPT 67255 or 66225. Final data collection ran on April 23, 2026. Possible confounding procedures such as cataracts were also excluded within the time period assessed in order to better localize the STAI for use in cases of scleritis. Results Out of 113,510,724 patients on the TriNetX database, 36,249 had a diagnosis of scleritis. Of those with a history of scleritis, 176 had a subconjunctival or subTenon triamcinolone injection (STAI). Of this cohort, 0 patients needed surgical interventions requiring a patch graft over the 15-year time period of the study giving an annual and cumulative incidence of 0 per 100,000 persons. The subjects were primarily female (112, 63.64%) with a mean age of 61 years (range 14-90, SD 16). Conclusions Surgical intervention requiring a patch graft was not observed post-injection among patients with prior scleritis who received a STAI. Further studies with larger cohorts are necessary to accurately represent the risk profile of STAI in the greater population.