Dropless Cataract Surgery May Worsen Postoperative Steroid Response

Dropless cataract surgery predisposes to greater incidence and longer duration of postoperative steroid response, according to findings presented at the American Academy of Ophthalmology (AAO) 2022 annual meeting, held in Chicago from September 30 to October 3.

Researchers conducted a study to assess rates of steroid response following dropless cataract surgery using a subconjunctival depot of triamcinolone vs conventional cataract surgery using topical prednisolone. The researchers reviewed consecutive cataract surgeries performed from January 2020 to September 2021, and defined steroid response as intraocular pressure (IOP) 50% above baseline or IOP more than 24 mm Hg postoperatively, excluding the first 72 hours. 

The researchers found that 26 eyes, of 150 dropless and 218 conventional cases, developed steroid response. Risk factors for steroid response included dropless cataract surgery (P =.04) and prior diagnosis of glaucoma (P =.0005), but did not include baseline IOP, age, and axial length. 

More dropless cataract surgery cases, of those with steroid responses, had IOP elevation lasting 30 days or more (10/15 eyes), compared with conventional surgery patients (1/11 eyes; P =.005). This included a patient who needed bilateral trabeculectomies for IOP control.