Outcome of pediatric cataract surgery with intraocular injection of triamcinolone acetonide: Randomized controlled trial

Purpose: To evaluate the use of intraocular injection of triamcinolone acetonide in pediatric cataract surgery with or without intraocular lens implantation as a vitreous dye to ensure a complete anterior vitrectomy and evaluate its effect on postoperative ocular inflammation, infection, posterior capsule opacification, and intraocular pressure. Methods: Randomized controlled trial included children diagnosed with bilateral congenital cataract in both eyes. Their eyes were randomly assigned into two groups: group A underwent aspiration, posterior capsulotomy, and anterior vitrectomy with intraocular injection of triamcinolone acetonide, while group B underwent the same surgical procedure without intraocular injection of triamcinolone acetonide. Intraocular pressure, postoperative inflammation, infection, and posterior capsule opacification were followed up till 6 months. Results: The study comprised 44 eyes of 22 children. The mean age was 2.4 ± 2.1 years including 10 males and 12 females. The mean postoperative intraocular pressure was within normal range in both groups. No case of infection in both groups. No eyes in group A showed reaction, while in group B, three eyes showed exudate on the first day, which improved at 2 weeks. Posterior synechiae was recorded in four eyes in group A and in five eyes in group B. Posterior capsule opacification was noted in one eye in group A at 3 month, while it was noted in nine eyes in group B. The difference was statistically significant ( p = 0.004). Conclusion: Triamcinolone acetonide was found to be useful in better visualization of vitreous in pediatric cataract surgery and has good effect in decreasing postoperative inflammation and posterior capsule opacification.