Outcomes of pediatric cataract surgery: Intraoperative triamcinolone injection versus dexamethasone injection

PURPOSE: To compare the clinical outcomes of cataract surgery by injecting intracameral triamcinolone or dexamethasone in children with bilateral congenital or developmental cataracts. DESIGN: Prospective, interventional, assessor-blinded, randomized controlled trial. METHODS: This was an institutional study in which 24 children aged <6 years with congenital/developmental cataracts were randomly divided into two groups. Eyes with other associated ocular conditions were excluded. Intracameral triamcinolone acetonide 1.2 mg/0.03 ml in the control group and dexamethasone 0.4 mg/0.1 ml in the study group were injected at the end of cataract surgery. The primary aim was to compare the number of eyes requiring surgery and postoperative outcomes such as anterior segment inflammation, intraocular lens pigment deposition, and posterior synechiae. RESULTS: The mean age was 20.04 months ± 17.88 (SD) (range 6 to 72 months) out of the 24 children being studied. One eye in the control group and three eyes in the study group required synechiolysis, membranectomy, and dialing of the intraocular lens with no statistically significant difference between the two groups (P = 0.60). The median intraocular pressure and central corneal thickness did not change significantly postoperatively in either group. Both groups showed similar cellular reactions and rate of complications. CONCLUSIONS: Intracameral dexamethasone can be used as an effective alternative to intracameral triamcinolone for modulating postoperative anterior segment inflammation in pediatric cataract surgery. This pilot study compares the safety and efficacy of two drugs used in pediatric cataract surgery, despite limitations such as a small sample size and a short follow-up period.