Dexamethasone versus triamcinolone acetonide for the management of postoperative inflammation following cataract surgery: A systematic review and meta-analysis.

In 30 seconds

This systematic review and meta-analysis compared dexamethasone with triamcinolone acetonide (TCA) for postoperative inflammation in adults undergoing phacoemulsification. It included 12 studies—nine randomised trials and three prospective non-randomised studies—with 2003 participants. Intraocular pressure did not differ significantly between treatments at any assessed time point up to 3 months, and anterior chamber flare and cells were also similar. TCA was associated with modest visual-acuity improvement at 7 and 28/30 days, but this finding was inconsistent in sensitivity analyses. Overall certainty of evidence was low.

Key findings

• Across 12 studies involving 2003 participants, intraocular pressure did not differ significantly between treatments at any time point up to 3 months.
• Anterior chamber flare and cell outcomes showed no significant differences between dexamethasone and TCA across assessed time points.
• TCA showed modest visual-acuity improvement at 7 and 28/30 days, but results were inconsistent on sensitivity analysis.
• A nonsignificant trend toward greater endothelial cell loss was observed with dexamethasone; overall evidence certainty was low.

Why it matters

Postoperative inflammation control aims to reduce complications such as cystoid macular edema and raised intraocular pressure. The review suggests broadly comparable outcomes with these two corticosteroids, while indicating that any short-term visual advantage with TCA is uncertain. Low evidence certainty means the comparative findings should be interpreted cautiously.

What to keep in mind

Overall evidence certainty was low, and the included evidence combined randomised trials with non-randomised prospective studies. The reported visual-acuity advantage for TCA was inconsistent on sensitivity analysis.