National Eye Institute/National Institutes of Health, Bethesda, Maryland, USA.
Retina. 2011 Feb;31(2):284-9. doi: 10.1097/IAE.0b013e3181f049a8.
To evaluate long-term effects of anterior and posterior peribulbar injections of triamcinolone acetonide on intraocular pressure (IOP) elevation and cataract development.
This study reports on IOP and cataract progression through 2 years in 96 eyes with diabetic macular edema randomized to focal/grid photocoagulation, 20 mg triamcinolone acetonide anterior injection, anterior injection followed by laser, 40 mg triamcinolone acetonide posterior injection, or posterior injection followed by laser.
Intraocular pressure increased from baseline by ≥ 10 mmHg at ≥ 1 visit through 2 years in 2 eyes (8%) in the laser group, 11 eyes (31%) in the anterior groups, and 6 eyes (17%) in the posterior groups. Among phakic eyes at baseline, 0, 5 (17%), and 1 (3%) in the 3 groups, respectively, underwent cataract surgery before the 2-year visit.
Based on this small randomized trial, it appears that over 2 years, anterior peribulbar triamcinolone acetonide injections are associated with an increased incidence of IOP elevation and an increased risk of cataract development compared with laser or posterior peribulbar injections. The association of posterior injections with IOP elevation is less certain. Although the study involved eyes with diabetic macular edema, the results should be relevant to other conditions treated with peribulbar corticosteroids.
评估曲安奈德前后球周注射对眼压升高和白内障发展的长期影响。
本研究报告了 96 只糖尿病性黄斑水肿眼通过 2 年的随访，随机分为局灶/格栅光凝组、20mg 曲安奈德前球周注射组、前球周注射后继以激光组、40mg 曲安奈德后球周注射组和后球周注射后继以激光组，观察眼压和白内障进展情况。
在 2 年的随访中，激光组有 2 只眼（8%）、前球周注射组有 11 只眼（31%）和后球周注射组有 6 只眼（17%）眼压升高≥10mmHg，至少有 1 次随访。在有晶状体眼的患者中，分别有 0、5（17%）和 1（3%）只眼在 2 年的随访前接受了白内障手术。
根据这项小型随机试验，在前球周注射曲安奈德后，在 2 年的时间内，眼压升高的发生率和白内障发展的风险均高于激光或后球周注射，与激光或后球周注射相比，前球周注射与眼压升高的相关性更高。后球周注射与眼压升高的相关性不太确定。虽然该研究涉及糖尿病性黄斑水肿眼，但结果可能与其他接受球周皮质类固醇治疗的疾病相关。
