I don’t do it often, but I will inject patients with diabetic macular edema with Kenalog. There is a problem with that, though, in that Triesence is available and is preservative-free, and therefore on a medico-legal standpoint, one would have a very hard time defending the use of Kenalog. Kenalog has preservatives and is not cleared for intravitreal use. Now, it’s true that at worst, some have noted a sterile endophthalmitis from Kenalog use which resolves with no loss of vision, but who wants to take a chance. Of course, the problem is that Triesence is $125.00 vs. $5.00 for Kenalog, but I suppose that’s a headache for insurance plans, not me. Be sure to bill separately for the injection as well as for the product (J3300)