Abstract
Purpose :
To compare the safety and efficacy of intraoperative triamcinolone-moxifloxacin (Imprimis’ Tri-Moxi 15mg/1mg/mL) injection versus postoperative polymyxin b/trimethoprim and prednisolone acetate 1% eye drops for infectious and inflammatory prophylaxis during the two-year postoperative period following phacoemulsification cataract surgery.
Methods :
From January through October 2017, patients undergoing cataract surgery by a single surgeon at Penn State Eye Center were offered a single intraoperative injection of transzonular triamcinolone-moxifloxacin in lieu of postoperative eye drops. From November 2017 through July 2018, this injection was not offered, and all patients were prescribed a postoperative regimen of polymyxin b/trimethoprim and prednisolone acetate 1%. A retrospective chart review was performed to record evidence of infectious sequelae, symptomatic uveitis, and elevated intraocular pressure (IOP) which occurred >10 weeks postoperatively.
Results :
Of the 198 eyes, 99 from 73 patients received the injection and 99 from 82 patients received topical drops. Follow-up for eyes in the injection group (25.0 months) was longer than in the drop group (16.2 months; p<0.0001). No patients experienced infectious sequelae in either group. All patients who developed rebound inflammation (defined as at least 1+ anterior chamber reaction with subjective patient complaints before postoperative week 10 [11 eyes in the injection group and 3 eyes in the drop group]) resolved with treatment without further episodes of intraocular inflammation. The mean IOP in the injection (14.6 mmHg) and drop (14.4 mmHg) groups were similar (p = 0.67). No patients had IOP above 23 mmHg in either group.
Conclusions :
Although triamcinolone-moxifloxacin was previously shown to be associated with higher rates of rebound inflammation relative to the topical drop regimen, long-term analyses suggest both groups of patients have similar outcomes with respect to uveitic sequelae, infectious complications, and elevated IOP.
This is a 2020 ARVO Annual Meeting abstract.