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Inflammation score on the anterior chamber in open-angle primary glaucoma patients accompanied by cataracts post phacotrabeculectomy with administration of intracameral dexamethasone injection is lower than subconjuntival dexamethasone injection

AAI Ratih Kemala Dewi , Made Agus Kusumadjadja, WG Jayanegara, WG

AAI Ratih Kemala Dewi
Department of Ophthalmology, Medical Faculty Udayana University/Sanglah Central General Hospital Denpasar. Email: ratih_axon@yahoo.com

Made Agus Kusumadjadja
Department of Ophthalmology, Medical Faculty Udayana University/Sanglah Central General Hospital Denpasar

WG Jayanegara, WG
Department of Ophthalmology, Medical Faculty Udayana University/Sanglah Central General Hospital Denpasar
Online First: August 03, 2018 | Cite this Article
Dewi, A., Kusumadjadja, M., Jayanegara, WG, W. 2018. Inflammation score on the anterior chamber in open-angle primary glaucoma patients accompanied by cataracts post phacotrabeculectomy with administration of intracameral dexamethasone injection is lower than subconjuntival dexamethasone injection. Bali Journal of Ophthalmology 2(1): 10-16. DOI:10.15562/bjo.v2i1.17


Background: Glaucoma with cataract is common in older patients and tends to increase worldwide as people age. Combination of glaucoma and cataract surgery will lead to a postoperative inflammatory response. Steroids are a major therapy in the management of postoperative inflammation. Intracameral steroid injection is selected because of the advantage of working directly in the anterior chamber.

Aims: This study aims to determine differences of an inflammatory score of the anterior chamber post phacotrabeculectomy in the administration of intracameral dexamethasone injection and subconjunctival dexamethasone injection.

Methods: This study is a randomized clinical trial with prospective repeated measurements. taking samples at Sanglah Denpasar Hospital and Bali Mandara Eye Hospital. A total of 28 eyes with primary open angle glaucoma with cataract were divided into groups receiving intracameral dexamethasone injection and subconjunctival dexamethasone injection. Data were analyzed with t-test, Friedman, Mann-Whitney, and repeated measurement.

Results: The median value of inflammatory cells between the two groups was different in day 1 (p=0.037) and 1 week (p=0.014) postoperative. The median flare values between the two groups were different in the 1 week postoperative (p=0.034).

Conclusion: This study found the intracameral dexamethasone suppressed inflammation in anterior chamber larger than subconjunctival dexamethasone in primary open angle glaucoma patients with cataract during the first day to 1-month post phacotrabeculectomy. Injection of intracameral dexamethasone can be the therapy of choice to reduce postoperative inflammation

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