June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Unplanned Initiation of Postoperative Topical Medications after Intravitreal Antibiotic-Steroid Injection during Cataract Surgery
Author Affiliations & Notes
  • Zeeshan Haq
    University of Chicago Pritzker School of Medicine, Chicago, Illinois, United States
  • Kamran Riaz
    Department of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States
  • Footnotes
    Commercial Relationships   Zeeshan Haq, None; Kamran Riaz, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 1828. doi:
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      Zeeshan Haq, Kamran Riaz; Unplanned Initiation of Postoperative Topical Medications after Intravitreal Antibiotic-Steroid Injection during Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1828.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : The incidence of, and risk factors for, elevated intraocular pressure (IOP) and breakthrough inflammation after intravitreal antibiotic-steroid injection during cataract surgery remain understudied. We performed a regression analysis of short-term results from a retrospective clinical cohort to test the hypothesis that previously implicated systemic and ocular factors may contribute to these postoperative complications.

Methods : The study includes 90 eyes (median age = 73.5 years; 56.7% female) from 64 patients who underwent uncomplicated phacoemulsification with an intravitreal antibiotic-steroid injection between 05/2016 and 11/2016. A single surgeon (K.R.) performed all of the cataract surgeries using a standardized technique for intravitreal injection at the conclusion of the surgery. All patients were followed for at least one month. Univariate logistic regression was used to identify potential predictors of unplanned topical pharmacotherapy initiation, which included age, glaucoma status, diabetes mellitus (DM), a history of laser treatment for DM, age-related macular degeneration, epiretinal membrane, previous history of intraocular inflammation, and a history of pars plana vitrectomy.

Results : The unplanned initiation of topical hypotensive medication for elevated IOP (> 30 mm hg) occurred in 10 eyes (11.1%) and was not significantly associated with a previous diagnosis of glaucoma or glaucoma suspect status (OR = 1.57; 95% CI = 0.29 to 8.37; p-value = 0.60). The unplanned initiation of topical corticosteroid and/or non-steroidal anti-inflammatory therapy for breakthrough inflammation occurred in 13 eyes (14.4%) and was not significantly associated with any of the tested predictors. Of 70 eyes that received a final refraction, a best corrected visual acuity of 20/25 or better was achieved in 60 eyes (85.7%). At the conclusion of the follow-up period, cystoid macular edema and endophthalmitis were diagnosed in 1 (1.1%) and 0 (0.0%) eyes, respectively.

Conclusions : Short-term outcomes of this technique are comparable to a standard postoperative regimen of topical medications. Further study of the factors that contribute to elevated IOP and breakthrough inflammation in the early postoperative period is necessary to identify patients at risk for these complications in whom an approach combining intravitreal and topical therapy may be appropriate.

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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