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Letters
January 1, 2008

Sterile Endophthalmitis After Benzyl Alcohol–Filtered Triamcinolone Acetonide Injection

Arch Ophthalmol. 2008;126(1):142-143. doi:10.1001/archophthalmol.2007.20

Several studies1,2 have described noninfectious endophthalmitis occurring after intravitreous triamcinolone acetonide (TA) injection. According to these articles, this complication occurs in 0.1% to 7% of eyes following treatment. Benzyl alcohol (BA), a bacteriostatic preservative in commercially available TA, has proven toxic to the rabbit eye in concentrations only modestly higher than those found in 0.1 mL of commercially available TA. This has led some investigators to hypothesize that BA may cause sterile endophthalmitis.3 Different techniques, namely, filtration, centrifugation, and sedimentation, were shown to reduce the concentration of BA by 90%.4

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