Abstract
Purpose :
Topical NSAIDS, corticosteroids, and antibiotics have been the mainstay for prophylaxis and treatment following cataract surgery to reduce inflammation and prevent post-op infectious endophthalmitis. Our study compares the outcomes of intraoperative pars plana intravitreal injection of Trimoxi + topical NSAID (“Dropless”) versus traditional eyedrop usage after cataract surgery. Our hypothesis was that the pars plana intravitreal injection of Trimoxi + topical NASAID is a non-inferior treatment method to standard eyedrop therapy for cataract surgery.
Methods :
This retrospective cohort study analyzed a total of 530 patients. 263 patients received standard therapy (4 four-week taper of antibiotic, NSAID and steroid eye drops) ; 267 patients received 0.2 mL of Trimoxi (Triamcinolone acetate – 15mg/mL ; Moxifloxacin – 1mg/mL) injected into the vitreous via the pars plana during cataract surgery + postop topical NSAID. Anterior chamber inflammation, corneal edema, and IOP were measured at 1 day, 1 week and 1 month postop. Other complications and modifications to the planned postop regimen were also noted.
Results :
A binary logistic regression shows no statistically significant differences between the two treatment groups across the three time points in all measured outcomes. Regarding anterior chamber inflammation (OR=0.997), no significant differences were detected between the treatment groups (p=0.9892). In the Dropless group, 22 eyes were given additional steroid drops postoperatively. In the standard eye drop regimen group 3 eyes required altered therapy (restart or increase the steroid/NSAID). A slight increase in the odds of corneal edema in the dropless group (OR=1.42) was found, although the p-value is not regarded as statistically significant (p=0.0815). Regarding postop IOP, there are decreased odds of elevated pressure in the dropless group (OR=0.651), but again there is no significant differences detected between treatment groups (p=0.1208).
Conclusions :
Intravitreal Trimoxi during cataract surgery + postop NSAID use appears non-inferior to traditional postop eyedrop use after cataract surgery. However, more patients in the dropless group required an alteration in the planned eye drop regimen versus the traditional group.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.