296 posters, 7 videos, 13 audios, 14 topics, 10 sessions, 1,019 authors, 259 institutions

RCOphth Annual Congress 2026

18 - 21 May, 2026 | Manchester Central, Manchester

P062

�Drop-free� Subconjunctival Triamcinolone Post-Cataract Surgery May Reduce Rate of Pseudophakic Cystoid Macular Oedema

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Poster Presenter

Alexander Fraser

Authors

Alexander Fraser, Yunfei Yang, Swetha Ravichandran, In-Jung Lee, Toby Al-mugheiry, James Myerscough

Part of Topic

Cataract and refractive surgery

“Drop-free” Subconjunctival Triamcinolone Post-Cataract Surgery May Reduce Rate of Pseudophakic Cystoid Macular Oedema

Authors: Alexander Fraser¹, Yunfei Yang¹, Swetha Ravichandran¹, In-Jung Lee¹, Toby Al-Mugheiry¹, James Myerscough¹

Affiliation: ¹ Southend University Hospital, Mid and South Essex NHS Foundation Trust, United Kingdom

Introduction:

Pseudophakic Cystoid Macular Oedema (PCMO) occurs in 0.1–2.5% after cataract surgery.¹ This may in part be driven by poor compliance with postoperative topical therapy regimes.² “Drop-free” steroid strategies aim to reduce treatment burden. Following its building popularity in independent practice,³ this service evaluation assesses safety and early outcomes of 4 mg subconjunctival triamcinolone acetonide (SCTA) (Kenalog® 40 mg/ml; Bristol-Myers Squibb, Princeton, NJ) in routine NHS practice.

Methods:

Retrospective audit of cataract surgeries using 4 mg SCTA

Single weekly half-day operating list (Mar–Sep 2025)

Inclusion: ≥1 month follow-up

Exclusion: operative complications or advanced glaucoma

Outcomes assessed: VA, refraction, PCMO, IOP spike (≥30 mmHg or rise ≥10 mmHg), signs of uveitis or endophthalmitis, and unplanned review or casualty visits

Results:

69 eyes (55 patients), mean age 74.5 ± 11.1 years, 58% male

Visual acuity improved Δ –0.28 logMAR (Figure 1)

65.6% and 95.1% met target ±0.50 D and ±1.00 D (Figure 2)

No major safety events observed (See Safety Outcomes)

Safety Outcomes:

0% PCMO rate – no episodes reported

0% clinically significant postoperative IOP rise observed

0% endophthalmitis – no cases reported

1 case uveitis (1.5%)* – patient with known recurrent uveitis

Conclusion:

SCTA was safe and well-tolerated in routine practice

No PCMO or clinically significant IOP rise observed

Visual & refractive outcomes meet benchmarks

Supports feasibility of a drop-free pathway

Requires prospective comparative validation

“SCTA appears safe and well-tolerated as part of a drop-free cataract pathway in routine NHS practice.”

References:

1. Shorstein NH, McCabe SE, Alavi M, Kwan ML, Chandra NS. Triamcinolone Acetonide Subconjunctival Injection as Stand-alone Inflammation Prophylaxis after Phacoemulsification Cataract Surgery. Ophthalmology. 2024;131(10):1145-1156. doi:10.1016/j.ophtha.2024.03.025

2. An JA, Kasner O, Samek DA, Lévesque V. Evaluation of eyedrop administration by inexperienced patients after cataract surgery. J Cataract Refract Surg. 2014;40(11):1857-1861. doi:10.1016/J.JCRS.2014.02.037

3. UKISCRS RECOMMENDATIONS United Kingdom and Ireland Society of Cataract and Refractive Surgeons (UKISCRS) Recommendations of Practice for Dropless Cataract Surgery 2026.

Link to practice preference survey: https://forms.gle/CvFtwHw8K6VtT1r39