Jornal de Oftalmologia Clínica e Experimental
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Intracameral Triamcinolone for the Treatment of Hyphema and Post-Surgical Iridocyclitis

Archimedes L.D. Agahan, Jose V. Tecson, Mario J. Valenton

Objective: This study investigates the clinical outcome of Triamcinolone acetonide injected intracamerally in patients with hyphema and post-surgical iridocyclitis.

Method: Retrospective chart review of all patients from 2000 to 2005 diagnosed with hyphema and post-surgical iridocyclitis were included. All patients were injected with 1 mg in 0.1 mL of triamcinolone acetonide intracamerally and given topical steroid and a broad spectrum anti-bacterial eye drops initially given 4x a day the frequency reduced according to clinical response.

Results: Twenty cases were identified (14 males, 6 females; mean age 40). Eight patients (40%) were diagnosed with hyphema while twelve patients (60%) had post-surgical iridocyclitis. The pre-treatment visual acuity is hand movement with good light projection in 11 cases (55%) and at least 20/200 for the remaining nine cases (45%). Sixteen patients (80%) exhibited improvement of visual acuity by at least 1 line by the time the hyphema or inflammation resolved. Post-treatment visual acuity in fourteen cases was better than 20/40 and two cases at least 20/200. Four patients exhibited adverse events which include transient increase in intraocular pressure, development of fungal keratitis, and endophthalmitis.

Conclusion: We recommend that intracameral triamcinolone injection may be used as an adjunct to topical corticosteroid for cases of hyphema and post-surgical iridocyclitis. It can also be considered an alternate mode of drug delivery for very severe cases of anterior segment inflammation refractory to conventional modes of steroid delivery. It is also recommended that the risk-benefit ratio be weighed before undertaking this invasive procedure because of its potential complications.