REVIEW ARTICLE


Review of Corticosteroid Use in Pediatric Cataract Surgery



Dian E. Yulia1, *, Indra M. Pambudy1, Lia Amanda1
1 Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia


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Creative Commons License
© 2021 Yulia et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Department of Ophthalmology, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia, Jl. Kimia No.8, Jakarta, Indonesia; Tel: +6281310568817; E-mail: dianestu.dianestu@gmail.com


Abstract

Introduction:

Following pediatric cataract surgery, an intense inflammatory response is related to various complications, including posterior capsule opacification (PCO), which is a visually threatening incidence that can lead to visual axis opacification (VAO). Although corticosteroids are essentially effective in reducing inflammation, potential ocular side effects are a remaining concern.

Objective:

This study aimed to review the efficacy and safety of corticosteroid drugs and their administration routes in pediatric patients who underwent cataract surgery

Methods:

A literature search was conducted from four electronic databases using keywords selected a priori. Identified articles were sorted according to the type of corticosteroid used, route of administration, and outcome measures, including inflammatory response and ocular side effects.

Results:

Five studies were included with one case series, one retrospective case-control, and three clinical trials. The total number of subjects was 311 patients, with an age range of six weeks to 15 years old. Four studies analyzed the use of triamcinolone acetonide intracamerally, which was superior to topical steroids. Most of the studies reported a decrease in inflammatory parameters. The outcome of PCO and VAO varied between studies. Nearly all the studies observed elevated intraocular pressure (IOP) as an ocular side effect.

Conclusion:

Various corticosteroids and different delivery routes can be used to ameliorate inflammation in pediatric cataract surgery. However, there is promising evidence suggesting intracameral steroids as substantially beneficial in reducing inflammatory parameters. Due to the limited number of studies reviewed, no firm conclusion regarding the superior steroid preparation or route of administration can be inferred. This review highlights the need for further studies.

Keywords: Pediatric cataract surgery, Corticosteroid, Inflammation, Posterior capsular opacification, Drug administration, Ocular side effect.