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  • Cataract/Anterior Segment, Uveitis

    Review of: Intravitreal versus oral steroids for inflammation control in uveitic patients undergoing cataract surgery

    Jamil M, Naz U, Naz S. Ocular Immunology and Inflammation, in press 2023

    Investigators sought to determine whether intravitreal or oral steroids were more effective at postsurgical inflammation control in patients with uveitis.

    Study design

    This 12-week, single-center, prospective study randomized 40 patients with inactive uveitis to either an intraoperative 4 mg/0.1 mL injection of intravitreal triamcinolone (IVTA) or perioperative oral prednisone 0.5 mg/kg/day starting 5 days prior to cataract surgery with a protocol-mandated taper after cataract surgery. Patients then underwent cataract surgery with IOL placement, and were treated postoperatively with topical steroids and cycloplegics per protocol.


    At weeks 1 and 4 following surgery, the IVTA group had significantly less inflammation than the prednisone group, but this difference between the groups disappeared by week 12. No patients in either group had a recurrence of uveitis. While there were no significant differences between the treatment groups in terms of BCVA, central macular thickness, or IOP, 5 patients given IVTA had postoperative IOP >21 mm Hg.


    The overall sample size was small and was limited to eyes without a prior history of steroid-related complication and no cystoid macular edema at baseline. There was no discussion of systemic steroid-related side effects.

    Clinical significance

    Control of inflammation in the perioperative period of cataract surgery is critical in patients with uveitis, and IVTA offers a safe and effective method to control inflammation while limiting systemic side effects. Given these promising early results, a larger multicenter clinical trial is needed to find out how patients will do overall.

    Financial Disclosures: Dr. Sumit Sharma discloses financial relationships with Abbvie, Alimera Sciences, Bausch + Lomb, Clearside Biomedical, Regenxbio (Consultant/Advisor); EyePoint Pharmaceuticals, Genentech, Regeneron Pharmaceuticals (Consultant/Advisor, Grant Support); Gilead Sciences, Ionis, Santen (Grant Support).