Triamcinolone acetonide suspension toxicity to corneal endothelial cells

PurposeTo investigate the cytotoxicity of triamcinolone acetonide (TA) suspensions to corneal endothelial cells (CECs).SettingDepartment of Ophthalmology, Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.MethodsNew Zealand white rabbit CECs were exposed for 1 minute to balanced salt solution (BSS); commercial TA suspension (cTA); vehicle-removed TA (–vTA); pure vehicle (V); 1/10 dilutions of cTA, –vTA, or V in BSS; or benzyl alcohol (BA) (cTA preservative) 9 mg/mL. Corneal endothelial cell toxicity was assessed by light microscopy (trypan blue staining) and transmission electron microscopy. The effects of 3-, 10-, or 30-minute exposures to 1/10 cTA, 1/10 –vTA, or V were also investigated.ResultsOne-minute exposures to –vTA or 1/10 –vTA did not damage CECs; however, cTA, V, or 1/10 dilutions of cTA or V caused damage and cells exposed to BA showed severe ultrastructural damage/lysis. A 30-minute exposure to 1/10 –vTA did not cause significant cell damage, whereas 3- to 30-minute exposures to 1/10 cTA or V showed significant time-dependent cytotoxicity.ConclusionsCommercial TA suspension was cytotoxic to cultured rabbit CECs because of the preservative, BA, in the vehicle. Because 1/10 –vTA appeared to be safe for up to 30 minutes of exposure, use of 1/10 dilutions of vehicle-removed TA is suggested to help surgeons visualize prolapsed vitreous during anterior vitrectomy in complicated cataract surgeries.