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Samantha Ayoub, Nathaniel Tracer, Daniela Alvarez, Nathan M Radcliffe; Association between intravitreal TriMoxi and IOP outcomes in microincisional glaucoma/cataract surgery. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4922.
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© ARVO (1962-2015); The Authors (2016-present)
Glaucoma patients who undergo cataract and microincisional glaucoma surgery (MIGS) are burdened with eye drop requirements. Intravitreal delivery of triamcinolone/moxifloxacin (TriMoxi) potentially eliminates the need for postoperative anti-inflammatory and antibiotic topical medications, but raises concern for increased steroid-related intraocular pressure (IOP). This study retrospectively compared IOP outcomes and glaucoma medication requirements in MIGS patients who received topical medications (Group 1) or TriMoxi injections (Group 2).
Fifty patients who underwent MIGS, using the VISCO360 instrument, from 2015 to 2016 were selected. Twenty-five patients received post-operative topical drops, including prednisolone acetate 1% and an antibiotic, and 25 patients received a TriMoxi intravitreal injection during surgery. Age and baseline IOP were matched between groups. IOP’s were collected from baseline to 6 months after surgery. The two groups were analyzed for differences in post-operative IOP and glaucoma medication drops.
The mean patient age was 66.3±8 years for Group 1 and 68.3±9.5 years for Group 2 (p >.05). The mean baseline IOP was 16.4 ± 3.4mmHg for Group 1 and 16.8±3.1mmHg for Group 2 (p >.05). There were no significant differences in postoperative IOP's at day 1, month 1, month 2, month 3, and month 6 between Group 1 (13.6±6.5, 15.2±4.5, 14.8±2.7, 14.3±4.3, 15.2±2.8mmHg) and Group 2 (12.4±5.3, 15±3.2, 14.9 ±3.9, 15±3, 14.4±4mmHg; p>.05 for all). Group 2 had lower IOP's at week 1 (17.84±8 vs. 13.75±4.3 mmHg, p<.05). There were no significant differences in glaucoma treatment eye drops taken at baseline or follow-up at week 1, month 1, month 2, month 3, and month 6 between Group 1 (1.28±0.74, 1.16±0.75, 1.05±0.80, 1±0.76, 0.89±0.78, 1.05±0.78) and Group 2 (1.24±1.42, 0.75±0.74, 0.67±0.82, 0.8±0.63, 0.8±0.84, 0.63±0.83; p>.05 for all). When considering total eye drop usage (including steroid and antibiotics), Group 2 used significantly fewer drops at week 1 (3.16±0.75 vs. 0.75±0.74, p<.05).
The use of intravitreal TriMoxi was not associated with IOP elevations or increased glaucoma medication requirements when compared to postoperative topical agents, but it did decrease total drop usage. TriMoxi injections may alleviate compliance issues with antibiotic and anti-inflammatory medications and potentially minimize burden on post-operative patients.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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