COMPARISON OF INTRA-OPERATIVE SUBTENON TRIAMCENOLONE ACETONIDE INJECTION WITH POST-OPERATIVE TOPICAL STEROID IN PHACOEMULSIFICATION

Authors

  • Shahzeb Ahmad Khyber Teaching Hospital (KTH), Peshawar, Pakistan. Author
  • Muhammad Adnan Khyber Teaching Hospital (KTH), Peshawar, Pakistan. Author
  • Hafiz Rohan Ahmad khan Khyber Teaching Hospital (KTH), Peshawar, Pakistan. Author
  • waqas khan Khyber Teaching Hospital (KTH), Peshawar, Pakistan. Author
  • Ansa Benazir Khyber Teaching Hospital (KTH), Peshawar, Pakistan. Author
  • Uzair Al-Shifa Trust Eye Hospital, Muzaffarabad, Pakistan. Author
  • Imran Ahmad Khyber Teaching Hospital (KTH), Peshawar, Pakistan. Author

DOI:

https://doi.org/10.71000/dpj6es10

Keywords:

Anti-Inflammatory Agents, Cataract Extraction, Corticosteroids, Eye Inflammation, Intraoperative Care, Phacoemulsification, , Sub-Tenon’s Injection

Abstract

Background: Postoperative inflammation remains a common and potentially vision-threatening complication after phacoemulsification. Conventional topical corticosteroid regimens, while effective, are often hindered by poor patient compliance, especially in low-resource settings. Depot steroid delivery systems such as sub-Tenon’s triamcinolone acetonide offer a promising alternative by ensuring sustained anti-inflammatory effects with reduced dosing frequency.

Objective: To compare the effectiveness of intraoperative sub-Tenon’s triamcinolone acetonide injection with postoperative topical steroids in preventing inflammation after uncomplicated phacoemulsification.

Methods: A randomized controlled trial was conducted at the Department of Ophthalmology, Khyber Teaching Hospital, involving 74 patients (aged 40–80 years) undergoing phacoemulsification. Patients were randomly allocated into two equal groups: Group A received a single intraoperative sub-Tenon’s injection of triamcinolone acetonide (40 mg/ml), while Group B was treated with 0.1% dexamethasone eye drops postoperatively. The primary outcome was the absence of inflammation, defined by anterior chamber cells ≤3 per high power field or absence of posterior synechiae, assessed at 4 weeks post-surgery.

Results: At 4 weeks follow-up, 83.8% of patients in Group A exhibited no signs of inflammation compared to 59.5% in Group B. The difference was statistically significant. Stratification analysis further revealed higher effectiveness among educated participants and urban residents. No significant adverse effects were noted in either group.

Conclusion: Intraoperative sub-Tenon’s triamcinolone acetonide was more effective than postoperative topical steroids in controlling inflammation after phacoemulsification. Its ease of administration and reduced reliance on patient compliance support its integration into routine cataract surgery protocols, particularly in populations where adherence to postoperative regimens is limited.

Author Biographies

  • Shahzeb Ahmad, Khyber Teaching Hospital (KTH), Peshawar, Pakistan.

    PGR FCPS ophthalmology, Department of Ophthalmology, Khyber Teaching Hospital (KTH), Peshawar, Pakistan.

  • Muhammad Adnan , Khyber Teaching Hospital (KTH), Peshawar, Pakistan.

    PGR FCPS ophthalmology, Department of Ophthalmology, Khyber Teaching Hospital (KTH), Peshawar, Pakistan.

  • Hafiz Rohan Ahmad khan, Khyber Teaching Hospital (KTH), Peshawar, Pakistan.

    PGR FCPS ophthalmology, Department of Ophthalmology, Khyber Teaching Hospital (KTH), Peshawar, Pakistan.

  • waqas khan, Khyber Teaching Hospital (KTH), Peshawar, Pakistan.

    PGR FCPS ophthalmology, Department of Ophthalmology, Khyber Teaching Hospital (KTH), Peshawar, Pakistan.

  • Ansa Benazir, Khyber Teaching Hospital (KTH), Peshawar, Pakistan.

     Clinical technologist ophthalmology, Department of Ophthalmology, Khyber Teaching Hospital (KTH), Peshawar, Pakistan.

  • Uzair, Al-Shifa Trust Eye Hospital, Muzaffarabad, Pakistan.

    Junior registrar, Al-Shifa Trust Eye Hospital, Muzaffarabad, Pakistan.

  • Imran Ahmad, Khyber Teaching Hospital (KTH), Peshawar, Pakistan.

    Associate professor Ophthalmology, Department of Ophthalmology, Khyber Teaching Hospital (KTH), Peshawar, Pakistan.

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Published

2025-07-19

How to Cite

1.
Ahmad S, Muhammad Adnan, Hafiz Rohan Ahmad khan, waqas khan, Ansa Benazir, Uzair, et al. COMPARISON OF INTRA-OPERATIVE SUBTENON TRIAMCENOLONE ACETONIDE INJECTION WITH POST-OPERATIVE TOPICAL STEROID IN PHACOEMULSIFICATION. IJHR [Internet]. 2025 Jul. 19 [cited 2025 Aug. 29];3(4 (Health and Allied):197-203. Available from: https://insightsjhr.com/index.php/home/article/view/1135