Intracameral dexamethasone injection in the treatment of cataract surgery induced inflammation: design, development, and place in therapy

Tirth J Shah,1 Mandi D Conway,1,2 Gholam A Peyman1,2 1Department of Ophthalmology, University of Arizona College of Medicine, Phoenix, Arizona, USA; 2Department of Ophthalmology, Tulane University College of Medicine, New Orleans, Louisiana, USA Abstract: Cataract surgery is one of the most common...

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Autores principales:	Shah TJ, Conway MD, Peyman GA
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	“Intracameral dexamethasone” “Intraocular steroids” “Cataract surgery” “Inflammation” “Topical steroids” “Dexycu” “Surodex” “Intraocular Pressure Cataract Surgery” Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/be7d8757d85047018834d009df0dfc81
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spelling	oai:doaj.org-article:be7d8757d85047018834d009df0dfc812021-12-02T01:52:33ZIntracameral dexamethasone injection in the treatment of cataract surgery induced inflammation: design, development, and place in therapy1177-5483https://doaj.org/article/be7d8757d85047018834d009df0dfc812018-11-01T00:00:00Zhttps://www.dovepress.com/intracameral-dexamethasone-injection-in-the-treatment-of-cataract-surg-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Tirth J Shah,1 Mandi D Conway,1,2 Gholam A Peyman1,2 1Department of Ophthalmology, University of Arizona College of Medicine, Phoenix, Arizona, USA; 2Department of Ophthalmology, Tulane University College of Medicine, New Orleans, Louisiana, USA Abstract: Cataract surgery is one of the most commonly performed surgeries worldwide, with nearly 20 million cases annually. Appropriate prophylaxis after cataract surgery can contribute to a safe and quick visual recovery with high patient satisfaction. Despite being the current standard of care, the use of multiple postoperative eye drops can create a significant burden on these patients, contributing to documented and significant non-adherence to the postoperative regimen. Over the past 25 years, there have been a few studies analyzing the use of intracameral dexamethasone (DXM) in controlling inflammation following cataract surgery. This review explores various drug delivery approaches for managing intraocular inflammation after cataract surgery, documenting the strengths and weaknesses of these options and examining the role of intracameral DXM (among these other strategies) in controlling postoperative intraocular inflammation. Intracameral DXM has a particular advantage over topical steroids in possibly decreasing postoperative inflammatory symptoms and objective anterior cell and flare scores. Compared to topical steroids, there may be a slightly less theoretical risk of significant intraocular pressure spikes and systemic absorption. In addition, surveys indicate patients prefer an intraoperative intracameral injection over a self-administered postoperative eye drop regimen. However, there are several adverse effects associated with intracameral DXM delivery that are not seen with the noninvasive topical approach. Although it is unlikely that intracameral DXM will replace topical medications as the standard management for postoperative inflammation, it is seemingly another safe and effective strategy for controlling postoperative inflammation after routine cataract surgery. Keywords: intracameral dexamethasone, intraocular steroids, cataract surgery, inflammation, topical steroids, Dexycu®, Surodex®, inflammation, intraocular pressure cataract surgeryShah TJConway MDPeyman GADove Medical Pressarticle“Intracameral dexamethasone”“Intraocular steroids”“Cataract surgery”“Inflammation”“Topical steroids”“Dexycu”“Surodex”“Inflammation”“Intraocular Pressure Cataract Surgery”OphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 12, Pp 2223-2235 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	“Intracameral dexamethasone” “Intraocular steroids” “Cataract surgery” “Inflammation” “Topical steroids” “Dexycu” “Surodex” “Inflammation” “Intraocular Pressure Cataract Surgery” Ophthalmology RE1-994
spellingShingle	“Intracameral dexamethasone” “Intraocular steroids” “Cataract surgery” “Inflammation” “Topical steroids” “Dexycu” “Surodex” “Inflammation” “Intraocular Pressure Cataract Surgery” Ophthalmology RE1-994 Shah TJ Conway MD Peyman GA Intracameral dexamethasone injection in the treatment of cataract surgery induced inflammation: design, development, and place in therapy
description	Tirth J Shah,1 Mandi D Conway,1,2 Gholam A Peyman1,2 1Department of Ophthalmology, University of Arizona College of Medicine, Phoenix, Arizona, USA; 2Department of Ophthalmology, Tulane University College of Medicine, New Orleans, Louisiana, USA Abstract: Cataract surgery is one of the most commonly performed surgeries worldwide, with nearly 20 million cases annually. Appropriate prophylaxis after cataract surgery can contribute to a safe and quick visual recovery with high patient satisfaction. Despite being the current standard of care, the use of multiple postoperative eye drops can create a significant burden on these patients, contributing to documented and significant non-adherence to the postoperative regimen. Over the past 25 years, there have been a few studies analyzing the use of intracameral dexamethasone (DXM) in controlling inflammation following cataract surgery. This review explores various drug delivery approaches for managing intraocular inflammation after cataract surgery, documenting the strengths and weaknesses of these options and examining the role of intracameral DXM (among these other strategies) in controlling postoperative intraocular inflammation. Intracameral DXM has a particular advantage over topical steroids in possibly decreasing postoperative inflammatory symptoms and objective anterior cell and flare scores. Compared to topical steroids, there may be a slightly less theoretical risk of significant intraocular pressure spikes and systemic absorption. In addition, surveys indicate patients prefer an intraoperative intracameral injection over a self-administered postoperative eye drop regimen. However, there are several adverse effects associated with intracameral DXM delivery that are not seen with the noninvasive topical approach. Although it is unlikely that intracameral DXM will replace topical medications as the standard management for postoperative inflammation, it is seemingly another safe and effective strategy for controlling postoperative inflammation after routine cataract surgery. Keywords: intracameral dexamethasone, intraocular steroids, cataract surgery, inflammation, topical steroids, Dexycu®, Surodex®, inflammation, intraocular pressure cataract surgery
format	article
author	Shah TJ Conway MD Peyman GA
author_facet	Shah TJ Conway MD Peyman GA
author_sort	Shah TJ
title	Intracameral dexamethasone injection in the treatment of cataract surgery induced inflammation: design, development, and place in therapy
title_short	Intracameral dexamethasone injection in the treatment of cataract surgery induced inflammation: design, development, and place in therapy
title_full	Intracameral dexamethasone injection in the treatment of cataract surgery induced inflammation: design, development, and place in therapy
title_fullStr	Intracameral dexamethasone injection in the treatment of cataract surgery induced inflammation: design, development, and place in therapy
title_full_unstemmed	Intracameral dexamethasone injection in the treatment of cataract surgery induced inflammation: design, development, and place in therapy
title_sort	intracameral dexamethasone injection in the treatment of cataract surgery induced inflammation: design, development, and place in therapy
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/be7d8757d85047018834d009df0dfc81
work_keys_str_mv	AT shahtj intracameraldexamethasoneinjectioninthetreatmentofcataractsurgeryinducedinflammationdesigndevelopmentandplaceintherapy AT conwaymd intracameraldexamethasoneinjectioninthetreatmentofcataractsurgeryinducedinflammationdesigndevelopmentandplaceintherapy AT peymanga intracameraldexamethasoneinjectioninthetreatmentofcataractsurgeryinducedinflammationdesigndevelopmentandplaceintherapy
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Intracameral dexamethasone injection in the treatment of cataract surgery induced inflammation: design, development, and place in therapy

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