Purpose: To assess the efficacy of a single subconjunctival triamcinolone acetonide injection as an alternative to topical steroids after cataract surgery in patients with ocular inflammatory disease.

Methods: A retrospective review was performed of 18 patients with ocular inflammatory diseases (i.e., scleritis, cicatrizing conjunctivitis, keratoconjunctivitis sicca) who received post-operative subconjunctival triamcinolone injection (0.1 - 0.2 ml, 40 mg/ml) after cataract surgery. Demographic information collected includes age at time of surgery, sex, race/ethnicity, and medical comorbidities. Primary outcomes include control of postoperative inflammation and incidence of postoperative complications. Control of postoperative inflammation will be evaluated by the maintenance or escalation of anti-inflammatory therapy from pre-operative baseline.

Results: 18 participants (11 female, 7 males; age range from 61 to 80 years) were included in the study. Ocular inflammatory diagnoses included graft-versus-host-disease, intermediate uveitis, keratoconjunctivitis sicca (Sjogren’s and non-Sjogren’s), scleritis, cicatrizing conjunctivitis, ocular rosacea, and other diseases. No significant postoperative complications occurred. 17 patients maintained or deescalated from baseline anti-inflammatory therapy (topical or systemic) postoperatively. One patient required a topical prednisone taper due to persistent anterior chamber inflammation at 1 month.

Conclusions: A single subconjunctival steroid injection after cataract surgery provided adequate control of postoperative inflammation in nearly all patients with ocular inflammatory disease. Consistent with prior studies, these findings suggest that outcomes of dropless cataract surgeries compare favorably to traditional topical regimens. Dropless regimens may be especially beneficial in patients with ocular inflammatory diseases, in which the toxic effects of drops may exacerbate existing inflammation. Thus, avoidance of postoperative drops may permit patients with inflammatory eye diseases to receive cataract surgery while maintaining or improving control of ocular inflammation.