Abstract
Purpose :
Intravitreal or intracameral antibiotic-steroid formulations are effective in preventing infection and controlling postoperative intraocular inflammation in cataract surgery. This study sought to compare the effectiveness of intravitreal triamcinolone acetonide-moxifloxacin versus intracameral dexamethasone-moxifloxacin-ketorolac in cataract surgery.
Methods :
A retrospective longitudinal comparative study among 401 consecutive eyes receiving either intraoperative triamcinolone acetonide-moxifloxacin or dexamethasone-moxifloxacin-ketorolac was performed between November 2016 and January 2020. Primary endpoints at postoperative day one (POD1), week one (POW1), and month one (POM1) included corneal edema, anterior chamber inflammation (ACI), and intraocular pressure (IOP).
Results :
On POD1, there was no statistically significant difference between the two groups (OR: 1.11 [0.66-1.86]; p=0.69) but at POW1, dexamethasone-moxifloxacin-ketorolac had significantly more ACI compared to triamcinolone acetonide-moxifloxacin (OR: 2.11 [1.22-3.66]; p=0.008). By POM1, there was no significant difference (p=0.98). At all time points, corneal edema severity was not significantly different. IOP was found to be significantly elevated in the triamcinolone acetonide-moxifloxacin group compared to the dexamethasone-moxifloxacin-ketorolac group by POM1 (15.64mmHg versus 13.16 mmHg, p=0.001). There was no statistical difference in rates of CME (OR: 0.13 [0.01-1.51]; p=0.06) and there were no cases of endophthalmitis.
Conclusions :
While triamcinolone acetonide-moxifloxacin demonstrates earlier postoperative inflammatory control compared to dexamethasone-moxifloxacin-ketorolac, both are effective in the postoperative recovery of cataract surgery. Additionally, intravitreal triamcinolone acetonide-moxifloxacin causes a slightly higher but significant IOP compared to intracameral dexamethasone-moxifloxacin-ketorolac. This study reinforces them as viable alternatives to traditional postoperative drops.
This is a 2021 ARVO Annual Meeting abstract.