Cataract Progression After Intravitreal Triamcinolone Injection

Purpose

To assess cataract progression after intravitreal 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.