Posterior Subtenon Triamcinolone Acetonide and Topical Corticosteroids for Postoperative Inflammation Control Following Small Incision Cataract Surgery: A Randomized Controlled Study

This is a prospective interventional randomized parallel group active controlled clinical trial conducted in the Department of Ophthalmology RL Jalappa Hospital and Research Centre Sri Devaraj Urs Medical College Kolar. The study aims to compare the efficacy and safety of posterior subtenon triamcinolone acetonide versus topical prednisolone one percent eye drops for controlling postoperative inflammation following uncomplicated small incision cataract surgery.

A total of 66 patients aged 40 years and above with operable age related cataract will be recruited after written informed consent and randomized equally into two groups. Group A will receive a single intraoperative posterior subtenon injection of triamcinolone acetonide 40 mg per mL 0.5 mL. Group B will receive standard postoperative topical prednisolone one percent eye drops in tapering doses over four weeks.

Randomization will be done using computer generated block randomization and allocation will be concealed using sequentially numbered sealed opaque envelopes. All surgeries will be performed by a single experienced surgeon under peribulbar anesthesia. Postoperative evaluation will be conducted by a blinded observer on postoperative days 1 7 and 30. Parameters assessed include anterior chamber inflammation cells and flare intraocular pressure visual acuity and adverse events.

The primary objective is to compare the degree of postoperative anterior chamber inflammation between the two groups. Secondary objectives include assessing intraocular pressure changes visual acuity outcomes patient compliance and incidence of steroid related complications. Statistical analysis will include descriptive statistics independent t tests Chi square and Fisher exact tests and repeated measures ANOVA to evaluate outcomes over time. Sample size is 33 per group to achieve 80 percent power at 95 percent confidence to detect a clinically significant difference in postoperative inflammation.

This investigator initiated academic study aims to determine whether a single posterior subtenon injection can provide comparable or superior anti inflammatory control to standard topical steroids potentially improving patient compliance and postoperative outcomes.