Efficacy of Tri-Moxi injection in cataract surgery of vitrectomized eyes

Abstract

Purpose : The introduction of compound drugs such as Tri-Moxi (triamcinolone acetonide/moxifloxacin) has decreased the number of eye drops need to be administered to cataract patients postoperatively. To our knowledge, there is no study that has evaluated the efficacy of Tri-Moxi injection during cataract surgery in viterctomized eyes. In this retrospective longitudinal study, we compared the efficacy of intravitreal Tri-Moxi injection to standard eye drop regimen with regard to postoperative inflammation.

Methods : We reviewed the electronic medical records of vitrectomized eyes underwent cataract surgery with intraocular lens implant using either intravitreal Tri-Moxi injection along with postoperative NSAID eye drop or standard eye drop regimen. The outcome measures included anterior chamber cell grade (non-inferiority test), corneal edema severity, and the rate of high IOP (≥ 21 mmHg), postoperatively.

Results : A total of 61 consecutive eyes (Tri-Moxi: 16, Standard: 45) of 58 patients were included in the study. Considering the non-inferiority margin (Δ) of +0.5 grade, Tri-Moxi was shown to be non-inferior to standard regimen in intraocular inflammation control postoperatively at week 1 (difference of -0.042 in mean anterior cell grade [95% CI -0.483-0.399]) and month 1 (difference of -0.301 in mean anterior cell grade [95% CI -0.631-0.030]) [Figure.1]. Anterior chamber inflammation decreased at a faster rate postoperatively with Tri-Moxi injection compared to standard regimen (regression coefficient: -1.094 vs. -0.717 for Tri-Moxi and Standard groups, respectively) [Figure.2]. Tri-Moxi injection was associated with increased severity of corneal edema early at postoperative day one (ordinal regression; P < .01), with no statistically significant difference later at week one postoperatively (P = .07). There was no statistically significant difference in the rate of high IOP between the two groups at any postoperative time points (chi-squared [χ²] test, P > 0.1 at all time points).

Conclusions : Tri-Moxi is effective in controlling intraocular inflammation after cataract surgery in vitrectomized eyes. It can be a promising substitute for conventional eye drop therapy, especially in patients with poor compliance.

This is a 2020 ARVO Annual Meeting abstract.

 

Comparison of anterior chamber cell grade with representation of confidence interval and non-inferiority margin (Δ) +0.50 grade.

 

Evolution of anterior chamber cell grade postoperatively.