Cataract progression after intravitreal triamcinolone injection

PURPOSE: To assess cataract progression after intra. vitreal triamcinolone injection. DESIGN: Retrospective, interventional, case-control study. METHODS: Forty-two phakic eyes of 37 patients were injected one, two, or three times with intravitreal triamcinolone for various indications. Noninjected phakic fellow eyes served as the control. The mean follow-up time for single injection was 12 months, for multiple injections was 14 months, and for control group was 13 months. Lens status, best-corrected visual acuity, and refractive errors were recorded at baseline and at each follow-up examination. RESULTS: At the last follow-up, changes in posterior subcapsular cataract and refractive error from baseline were significantly different between single triamcinolone-injected eyes and the control group [0.7 +/- 0.2 (mean SEM [arbitrary unit] vs 0.2 +/- 0.1, P =.02; and -0.5 0.1 diopter vs -0.2 +/- 0.1 diopter, P =.01, respectively). For multiple-injected eyes and control eyes, change from baseline in corticonuclear cataract (1.1 +/- 0.2 vs 0.2 +/- 0.1) posterior subcapsular cataract (1.1 +/- 0.2) and refractive error (-1.8 +/- 0.4 diopters) were significantly different (P <.001, P <.001, and P <.001, respectively). Visual acuity did not change after single injection (P =.83) and in control group (P =.19) but decreased after multiple injections (P =.006). Eleven study eyes and two control group eyes underwent cataract extraction during study period. Corticonuclear and posterior subcapsular cataract progression significantly correlated with follow-up time (P =.003 and P =.02, respectively) and number of injections (P =.01 and P =.04, respectively). CONCLUSIONS: Single intravitreal triamcinolone injection induces posterior subcapsular cataract development, whereas multiple injections result in all-layer cataract progression. (c) 2005 by Elsevier Inc. All rights reserved.