Intravitreal injection with or without topical NSAID for cataract prophylaxis

Session Details

Session Title: Cataract Surgery Special Cases

Session Date/Time: Monday 12/09/2016 | 08:00-10:30

Paper Time: 09:28

Venue: Auditorium C6

First Author: : K.Solomon USA

Co Author(s): :    S. Lane   D. Hardten   H. Sandoval              

Abstract Details

Purpose:

To evaluate the efficacy of an intravitreal injection containing triamcinolone acetonide, moxifloxacin and vancomycin with or without a topical NSAID used during routine cataract surgery and intraocular lens (IOL) implantation compared to standard prophylactic treatment (moxifloxacin 0.5% QID and nepafenac 0.3% QD starting 3 days prior to surgery and prednisolone acetate 1% starting after surgery QID for 2 weeks then BID for another 2 weeks).

Setting:

Carolina Eyecare Physicians, Charleston, SC, USA; Associated Eye Care, Stillwater, MN, USA; Minnesota Eye Consultants, Bloomington, MN, USA.

Methods:

Prospective study that included patients undergoing routine phacoemulsification and IOL implantation. Patients were randomized to TriMoxi+Vancomycin (TMV-group) or TMV+Nepafenac 0.3% QD starting 3 days prior to surgery (TMVI-group). Within each group, eyes were randomized to injection or drops (control eye). Anterior chamber (AC) cells, flare, pachymetry, IOP, and presence of floaters were evaluated preoperatively, 1, 15 and 30 days after surgery. Central macular thickness-CMT was measured preoperatively and Day 15 and 30. Comparisons between the groups were made. Statistical analysis was conducted base on the distribution of the data using parametric or non-parametric tests as deemed necessary.

Results:

56 patients have been enrolled. No significant differences in preoperative measurements, surgical time, CDE or amount of fluid used (P > .05). AC cells, IOP and pachymetry were significantly higher at Day 1 relative to baseline in all groups; yet, there were no statistically significant differences in change over time between groups. Similarly, there was a significant increase on Day 15 and 30 in CMT but no differences between groups. A higher percentage of patients reported floaters postoperatively in both injection groups compare to the control group on day 1. No intraoperative complications related to the injection were seen.

Conclusions:

Our results show that the prophylactic treatment using an intravitreal injection at time of cataract surgery is as effective as the current standard of care (drops).

Financial Disclosure:

... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented