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

Gillies, Mark C. and Islam, Fakir M. A. and Larsson, Jorgen and Pasadhika, Sirichai and Gaston, Chris and Zhu, Meidong and Wong, Tien Y. (2010) Triamcinolone-induced cataract in eyes with diabetic macular oedema: 3-year prospective data from a randomized clinical trial. Clinical and Experimental Opthalmology, 38 (6). pp. 605-612. ISSN 1442-6404

Abstract

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.


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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: © 2010 Royal Australian and New Zealand College of Ophthalmologists.
Depositing User: epEditor USQ
Faculty / Department / School: Historic - Faculty of Sciences - Department of Maths and Computing
Date Deposited: 18 Jan 2012 06:35
Last Modified: 10 Oct 2014 03:30
Uncontrolled Keywords: cataract surgery; IVTA injection; macular oedema; visual acuity
Fields of Research (FOR2008): 11 Medical and Health Sciences > 1113 Ophthalmology and Optometry > 111301 Ophthalmology
11 Medical and Health Sciences > 1101 Medical Biochemistry and Metabolomics > 110107 Metabolic Medicine
11 Medical and Health Sciences > 1113 Ophthalmology and Optometry > 111303 Vision Science
Socio-Economic Objective (SEO2008): C Society > 92 Health > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920104 Diabetes
Identification Number or DOI: doi: 10.1111/j.1442-9071.2010.02341.x
URI: http://eprints.usq.edu.au/id/eprint/20627

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