Abstract
Purpose :
To report the effect of intravitreal triamcinolone acetonide-moxifloxacin on the presence of macular edema after cataract surgery in patients with pre-existing diabetic macular edema.
Methods :
This retrospective chart review involved a total of 64 patients and 75 eyes who had cataract surgery between February 2015 and September 2018 performed by two surgeons at Loma Linda University Eye Institute. Intravitreal injection of triamcinolone-moxifloxacin (15 mg/1mg/ml, 0.2 ml injection with 3.0 mg triamcinolone acetonide and 0.2 mg moxifloxacin) was given at the time of surgery. Visual acuity and central macular thickness (CMT) with OCT was recorded pre-operatively and post-operatively.
Results :
Mean visual acuity (logMAR) one day after surgery was 0.55, improved to 0.43 one week post-operatively, and improved further to 0.41 one month postoperatively. One subject was lost to follow up for visual acuity before the one week visit, and another subject had no light perception at baseline. Baseline mean CMT of 75 eyes was 294 µm (72). Mean CMT at 4-6 week post-operatively for 46 eyes decreased from 299 μm (78) to 297 µm (79), with an average decrease of 2 µm (50). Mean CMT at a 6-12 weeks post-operatively for 34 eyes increased from 317 µm (88) to 344 µm (111), with an average increase of 26 µm (98). Mean CMT at 12 weeks or more post-operatively for 60 eyes increased from 295 µm (72) to 328 µm (108), with an average increase of 33 µm (85).
Conclusions :
In this study, patients demonstrated improved visual acuity at one week post-operatively and further improvement at one month post-operatively. This expected improvement was likely due to the removal of the cataract itself. The data supports Triamcinolone acetonide-Moxifloxacin maintaining stability of post-operative macular edema (CMT) in patients undergoing cataract surgery with pre-existing diabetic macular edema in the short term, with the greatest effect at 4-6 weeks post-operatively. The results of this study did not show strong support of triamcinolone acetonide-moxifloxacin preventing worsening of edema at intervals greater than 6 months. Further investigation outside of this single institution, two surgeon study is warranted to determine isolated benefit of triamcinolone acetonide-moxifloxacin use.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.