Young patient age and poor glycemic control were risk factors for postoperative central retinal thickness increase. This study showed it is necessary to identify, effectively treat, and follow-up with patients with diabetes who are at a greater risk for pseudophakic CME.

Purpose: To compare the efficacy, safety and tolerability of a single perioperative subconjunctival injection of triamcinolone acetonide (TA) with steroid drops for the prevention of macular oedema and ocular inflammation after cataract surgery. Methods: This prospective non-randomized controlled clinical trial analysed 101 eyes of 101 patients having an elective cataract surgery at Kymenlaakso Central Hospital, Kotka, Finland. Fifty eyes received conventional postoperative care with dexamethasone 1 mg/ml eye drops (DEX), and 51 eyes received a perioperative 20 mg subconjunctival injection of TA. None of the eyes received postoperative topical antibiotic prophylaxis. The main outcome measures were aqueous flare, central retinal thickness (CRT), corrected distance visual acuity (CDVA) and intraocular pressure (IOP) measured at 7, 28 and 90 days after surgery.Results: Central retinal thickness (CRT) increased in DEX but not in TAtreated eyes at 7 days (+1.2 AE 20.1 lm and À9.2 AE 24.8 lm, p = 0.031), at 28 days (+23.8 AE 62.6 lm and À3.3 AE 27.7 lm, p = 0.008) and at 90 days (+8.5 AE 24.4 lm and À5.5 AE 33.4 lm, p = 0.026). Aqueous flare increased from baseline in both groups but remained higher in DEX eyes at 90 days (+3.3 AE 9.9 photons/ms and À0.2 AE 6.6 photons/ms, p = 0.021). Corrected distance visual acuity (CDVA) and IOP changes were similar, and ocular tolerance was good in both groups. No serious adverse events were observed. Conclusions: Perioperative subconjunctival TA was effective in preventing ocular inflammation and macular oedema after cataract surgery. Subconjunctival TA combined with intracameral cefuroxime provides a noteworthy option for dropless postoperative care in modern cataract surgery.

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