Combinative Approach of Transzonular Triamcinolone-Moxifloxacin and Perioperative Drops to Minimize Postoperative Complications of Cataract Surgery

Abstract

Purpose : To investigate the effectiveness of combination therapy with transzonular triamcinolone-moxifloxacin (Tri-Moxi) and conventional perioperative drops in reducing postoperative complications of cataract surgery.

Methods : Electronic medical records of cataract surgery patients (single surgeon) were reviewed from January 2018 to September 2021. The rate of postoperative complications including prolonged and/or recurrent postoperative inflammation, endophthalmitis, cystoid macular edema (CME), and intraocular pressure (IOP) was compared between the patients receiving combinative therapy (Tri-Moxi plus drops) and patients receiving drops only.

Results : 596 patients and 1057 eyes (Combinative-Therapy group 493 and Drop-Only group 564) were included in this study. Using combination therapy reduced the relative risk of postoperative inflammation by 26.9% (16.6% Combinative-Therapy vs. 22.7% Drop-Only, P=0.013). The incidence of endophthalmitis was 0% in the Combinative-Therapy group vs. 0.5% in the Drop-Only group (relative risk reduction 100%), although not statistically significant (P=0.10). The incidence of severe IOP spikes was not significantly different between Combinative-Therapy (2.4%) and Drop-Only (1.6%) groups (P=0.33). The relative risk of postoperative CME was 51.4% less in three months follow-up visit in the Combinative-Therapy group, although not statistically significant (P=0.07). The visual outcome 1-month postop (BCVA) was significantly better in Combinative-Therapy (LogMAR 0.10) compared to Drop-Only (LogMAR 0.14) groups (P=0.02) while the baseline visual acuity was not significantly different.

Conclusions : The combinative approach of transzonular triamcinolone-moxifloxacin plus perioperative eyedrops is an effective method to minimize postoperative inflammation, with better visual outcomes. It could potentially reduce the risk of postoperative endophthalmitis and CME (near-significant P-values; larger studies could analyze better considering low incidence).

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.