Retinal deposits of triamcinolone-moxifloxacin after dropless cataract surgery.

PURPOSE:To report a case of epiretinal crystalline deposits observed on fundus examination and optical coherence tomography 2 years after transzonular intravitreal injection of triamcinolone-moxifloxacin (TriMoxi) during "dropless" cataract surgery. METHODS:Observational case report with literature review of toxic effects of intravitreal triamcinolone and differential diagnosis of retinal crystalline deposits. RESULTS:A 37-year-old asymptomatic pseudophakic man presented with refractile crystalline retinal deposits that had prompted an extensive systemic embolic workup. The systemic evaluation for emboli was negative. OCT imaging revealed that the crystalline deposits were confined to the anterior surface of the internal limiting membrane. Further historical inquiry determined that transzonular intravitreal triamcinolone-moxifloxacin injection had been performed at the time of cataract surgery 2 years earlier. CONCLUSION:Transzonular triamcinolone acetonide delivered during cataract surgery can deposit on the retinal surface for long periods. These epiretinal crystalline deposits are benign and generally do not interfere with visual acuity. Nevertheless, clinicians should be aware of this differential diagnosis because clinical misdiagnosis can lead to unwarranted evaluation and treatment.