# Perioperative subconjunctival steroid injection in dropless cataract surgery: a systematic review and meta-analysis

## TL;DR

This study compares the effectiveness of subconjunctival steroid injections and eye drops in cataract surgery and finds no significant difference in outcomes.

## Contribution

A systematic review and meta-analysis comparing subconjunctival steroid injections and topical steroids in dropless cataract surgery.

## Key findings

- No significant differences were found in macular edema, visual acuity, or laser flare count between the two groups.
- Both subconjunctival injections and topical steroids showed comparable efficacy and safety in controlling postoperative inflammation.
- The study highlights the need for further research to validate these findings.

## Abstract

The advantages and disadvantages of using perioperative subconjunctival steroid
injections in dropless cataract surgery continue to be debated. A systematic
review of PubMed, EMBASE, and the Cochrane Central database identified five
studies—two randomized controlled trials and three non-randomized
studies—encompassing 70,751 eyes. Among these, 12,319 eyes (17.4%) received
subconjunctival steroid injections, while 58,432 eyes (82.6%) were managed with
topical steroids. The Cochrane Collaboration’s RoB 2 tool was applied for bias
assessments in randomized controlled trials, and heterogeneity was assessed
using the I² statistics. No statistically significant differences were found
between the two groups regarding macular edema (p=0.249), visual acuity
(p=0.73), or laser flare count (p=0.45). Both subconjunctival injections and
topical steroids demonstrated comparable efficacy and safety in controlling
postoperative inflammation after cataract surgery. Additional research is
warranted to validate these conclusions.