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Triamcinolone-induced cataract in eyes with diabetic macular oedema: 3-year prospective data from a randomized clinical trial

Gillies, Mark C.; Islam, Fakir M. A.; Larsson, Jörgen LU ; Pasadhika, Sirichi; Gaston, Chris; Zhu, Meidong and Wong, Tien Y. (2010) In Clinical and Experimental Ophthalmology 38(6). p.605-612
Abstract
P>Purpose: To describe the 3-year risk of cataract after intravitreal triamcinolone (IVTA) injections for diabetic macular oedema and the outcomes of cataract surgery. Methods: Prospective data from a randomized clinical trial were analysed. At baseline, 27 phakic eyes with diabetic macular oedema were randomized to receive IVTA and 25 to receive sham injection. After 2 years, initial sham-treated eyes were eligible to receive IVTA as the study became open label for the third year. The cumulative incidence of cataract surgery was the primary outcome of the study. Other outcomes assessed included progression of cataract, best-corrected logarithm of the minimal angle of resolution visual acuity before and after surgery and central macular... (More)
P>Purpose: To describe the 3-year risk of cataract after intravitreal triamcinolone (IVTA) injections for diabetic macular oedema and the outcomes of cataract surgery. Methods: Prospective data from a randomized clinical trial were analysed. At baseline, 27 phakic eyes with diabetic macular oedema were randomized to receive IVTA and 25 to receive sham injection. After 2 years, initial sham-treated eyes were eligible to receive IVTA as the study became open label for the third year. The cumulative incidence of cataract surgery was the primary outcome of the study. Other outcomes assessed included progression of cataract, best-corrected logarithm of the minimal angle of resolution visual acuity before and after surgery and central macular thickness. Results: Over the 3 years of the study, 15/27 (56%) phakic eyes in the IVTA treated group underwent cataract surgery as compared with 2/25 (8%) initial sham-treated eyes (P < 0.001). Mean visual acuity 6 months after cataract surgery was better than at entry into the trial. Two (15%) of the eyes in the IVTA-treated group undergoing cataract surgery had a loss of > 15 letters. In the IVTA-treated group, 10/15 (67%) eyes that had three or more injections had progression of posterior subcapsular cataract by >= 2 grades as compared with only 2/12 (17%) eyes that had fewer than three injections (P = 0.009). Conclusions: Over half of the eyes receiving IVTA injections for diabetic macular oedema required cataract surgery within 3 years. In eyes with three or more IVTA injections, two-thirds had progression of posterior subcapsular cataract. Visual outcomes after cataract surgery were generally good, although a small proportion of eyes lost greater than 15 letters over the course of the study. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
visual acuity, macular oedema, cataract surgery, IVTA injection
in
Clinical and Experimental Ophthalmology
volume
38
issue
6
pages
605 - 612
publisher
Wiley-Blackwell
external identifiers
  • wos:000280651800012
  • scopus:77955346303
ISSN
1442-6404
DOI
10.1111/j.1442-9071.2010.02341.x
language
English
LU publication?
yes
id
c91df104-9d78-465d-a352-15adf48db5e2 (old id 1678455)
date added to LUP
2010-09-21 09:26:51
date last changed
2018-05-29 11:13:21
@article{c91df104-9d78-465d-a352-15adf48db5e2,
  abstract     = {P&gt;Purpose: To describe the 3-year risk of cataract after intravitreal triamcinolone (IVTA) injections for diabetic macular oedema and the outcomes of cataract surgery. Methods: Prospective data from a randomized clinical trial were analysed. At baseline, 27 phakic eyes with diabetic macular oedema were randomized to receive IVTA and 25 to receive sham injection. After 2 years, initial sham-treated eyes were eligible to receive IVTA as the study became open label for the third year. The cumulative incidence of cataract surgery was the primary outcome of the study. Other outcomes assessed included progression of cataract, best-corrected logarithm of the minimal angle of resolution visual acuity before and after surgery and central macular thickness. Results: Over the 3 years of the study, 15/27 (56%) phakic eyes in the IVTA treated group underwent cataract surgery as compared with 2/25 (8%) initial sham-treated eyes (P &lt; 0.001). Mean visual acuity 6 months after cataract surgery was better than at entry into the trial. Two (15%) of the eyes in the IVTA-treated group undergoing cataract surgery had a loss of &gt; 15 letters. In the IVTA-treated group, 10/15 (67%) eyes that had three or more injections had progression of posterior subcapsular cataract by &gt;= 2 grades as compared with only 2/12 (17%) eyes that had fewer than three injections (P = 0.009). Conclusions: Over half of the eyes receiving IVTA injections for diabetic macular oedema required cataract surgery within 3 years. In eyes with three or more IVTA injections, two-thirds had progression of posterior subcapsular cataract. Visual outcomes after cataract surgery were generally good, although a small proportion of eyes lost greater than 15 letters over the course of the study.},
  author       = {Gillies, Mark C. and Islam, Fakir M. A. and Larsson, Jörgen and Pasadhika, Sirichi and Gaston, Chris and Zhu, Meidong and Wong, Tien Y.},
  issn         = {1442-6404},
  keyword      = {visual acuity,macular oedema,cataract surgery,IVTA injection},
  language     = {eng},
  number       = {6},
  pages        = {605--612},
  publisher    = {Wiley-Blackwell},
  series       = {Clinical and Experimental Ophthalmology},
  title        = {Triamcinolone-induced cataract in eyes with diabetic macular oedema: 3-year prospective data from a randomized clinical trial},
  url          = {http://dx.doi.org/10.1111/j.1442-9071.2010.02341.x},
  volume       = {38},
  year         = {2010},
}