Cataract Surgery Pre-Kenalog injection

[Luvtoski]

How common is it for a Cataract surgeon to insist on a Kenalog injection one week before Cataract Surgery?

I went to 4 Specialists for opinions since I wanted to get the Best of the Best for my cataract surgery.  I had an Membrane Peel/ Vitrectomy 9 months ago, so I realize the Cataract surgery needs to be done more carefuly.

Only one of the Specialists recommends the Pre-Kenalog injection (and he is the Surgeon I like in all other regards)...so I am doubtful I should get it.  My retina has settled from surgery, Macula thickness now 308 and no CME.  This Cat. Sp. says he routinely has his Retina Sp. do a Kenalog injection one week before his Cat. surgery to help prevent CME post surgery.

Is this common in the industry ?  What are the "downsides" to this Kenalog injection, and is it worth it ?
Thank you !

  

[Luvtoski]

Thank you Dr. O. for the detailed answer...I was thinking along the same lines but am certainly no expert.

I asked the Dr. if we couldn't just do a Kenalog injection if or when CME would occur post surgery, but he said it was much more effective doing it a week before as a preventative.  

So much to consider with these details, but ultimately I am the one who has to live with the results and potential side effects so I believe it is worth putting this time into my decision.

You Doctors that answer these forum questions are the best !

[Ray T Oyakawa, MD]

This is not a common practice.   The Kenalog can cause glaucoma that is difficult to control in eyes that are steroid responders.  The drug last about 90 days.  Avastin might be a better choice if he is that concerned.

I use NSAID (Bromday) and a strong steroid (Durezol) for about two months post op and inject Avastin if CME occurs in this type of case.


Dr. O.