A Single Intraoperative Sub-Tenon’s Capsule Injection of Triamcinolone and Ciprofloxacin in a Controlled-Release System for Cataract Surgery

Paganelli, Fernando; Cardillo, J.A.; Melo, Luiz Alberto S.; Lucena, D. R.; Silva, Arnobio A.; Oliveira, Anselmo Gomes de; Höfling-Lima, Ana Luísa; Nguyen, Quan Dong; Kuppermann, Baruch D.; Belfort, Rubens

doi:10.1167/iovs.08-2920

Cited by 26 publications

(30 citation statements)

References 42 publications

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“…Following a posterior 40-mg triamcinolone sub-Tenon's capsule injection, an incidence of increased IOP that was lower than expected was surprisingly observed (Paganelli et al, 2004). In our most recently study, only one eye (triamcinolone group) had an IOP that exceeded 25 mmHg, and the IOP returned to a normal level with topical antihypertensive drops (Paganelli et al, 2009). However, beyond our 28-day follow-up period, delayed onset of increased IOP must be considered.…”

Section: Introductionmentioning

confidence: 69%

“…This hinders the exploration of novel therapeutic approaches for the eye with appropriate newer molecules and better engineered drug delivery technologies. To the best of our knowledge our recently published investigations open up a new era offering the potential of no need for postoperative drops in cataract surgery (Paganelli et al, 2004;Paganelli et al, 2009;Cardillo et al, 2010). These studies gave new information and substantiated a novel and optimized antibiotic prophylaxis strategy using slow delivery technology.…”

Section: Subconjunctival Delivery Of Antibiotic In Controlled-releasementioning

confidence: 99%

“…In vivo there were no drug or procedure-related adverse events and no inflammatory cells or fibrous tissue response at the site of injection was observed. Clinically, in addition to its minimally invasive and pharmaceutically acceptable nature, no drug or procedure-related adverse events occurred (Paganelli et al, 2009;Cardillo et al, 2010). Pharmacokinetic profiles of aqueous and vitreous humor in rabbit eyes using 0.2 mg/0.1mL of ciprofloxacin microspheres or 2 mg/0.1mL of free ciprofloxacin were compared to a single drop of 0.3% ciprofloxacin six times a day.…”

Section: Subconjunctival Delivery Of Antibiotic In Controlled-releasementioning

confidence: 99%

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Trans-Scleral Controlled-Release of Drugs for Cataract Surgery

Oliveira¹,

Cardillo²,

Paganelli³

et al. 2013

Cataract Surgery

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Section: Introductionmentioning

confidence: 69%

Section: Subconjunctival Delivery Of Antibiotic In Controlled-releasementioning

confidence: 99%

Section: Subconjunctival Delivery Of Antibiotic In Controlled-releasementioning

confidence: 99%

See 1 more Smart Citation

Trans-Scleral Controlled-Release of Drugs for Cataract Surgery

Oliveira¹,

Cardillo²,

Paganelli³

et al. 2013

Cataract Surgery

Self Cite

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“…Weber et al (11) also indicated the efficacy and safety of IND eye drops compared with ketorolac 0.5% eye drops in the management of ocular inflammation after cataract surgery. Further, anti-inflammation of CIP effects for inhibition of conjunctival bacterial flora after cataract surgery has been analyzed in a controlled-release system (10). In this study, we compared the efficacy of DEX, IND and CIP in improving AC inflammation, intra-ocular pressure and final visual outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Previous reports have indicated that DEX, indomethacin (IND), ciprofloxacin (CIP) presented anti-inflammation activity for patients with cataract (8)(9)(10)(11). On these premises, we sought to compare anti-inflammation among DEX, IND and CIP in controlling immediate inflammation after cataract surgery in clinical treatment.…”

Section: Introductionmentioning

confidence: 99%

The role of Dexamethasone in clinical pharmaceutical treatment for patients with cataract surgery

et al. 2017

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Abstract. The aim of the present study is to determine the efficacy of dexamethasone (DEX) vs. indomethacin (IND) and ciprofloxacin (CIP) in modulating immediate inflammation following cataract surgery. A total of 644 patients with cataract were recruited and inflammation was investigated during the perioperative period. The management protocol was similar in both groups. Each drug was given four times a day for 30 days starting 7 days prior to surgery. The primary efficacy criteria for evaluation were the reduction in anterior chamber (AC) flare and AC inflammation score, in addition, a different secondary efficacy and safety evaluation criteria were maintained. The results demonstrated that the average inflammation score was 1.2±0.8 in the DEX group, which was significantly lower compared with the IND (1.9±0.7) and CIP (1.8±0.6) groups. Intra-ocular pressure was decreased following treatment with DEX, while intra-ocular pressure was slightly increased in the IND (1.9±0.7) and CIP (1.8±0.6) groups. The final visual outcomes for patients postcataract surgery were clinically superior in the DEX group compared with that of the IND and CIP groups (P=0.034 and P=0.042, respectively), but there was no significant difference between the ND and CIP groups (P= 0.78). Outcomes indicated that AC inflammation, conjunctival hyperaemia, corneal and lid oedema, ocular infection, pain, photophobia, and tearing were significantly improved in each group. No significant poor local tolerance or adverse reaction was observed in the DEX, IND and CIP groups. In conclusion, the outcomes of the present study suggest that DEX serves an important role in the clinical pharmaceutical treatment of patients with cataract surgery.

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Subconjunctival Delivery of Antibiotics in a Controlled-Release System

et al. 2010

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To compare the efficacy of subconjunctival injection of a combination of triamcinolone and ciprofloxacin hydrochloride, 2 mg/0.1 mL, in a controlledrelease system (DuoCat) with that of ciprofloxacin hydrochloride, 0.3%, eyedrops for infection prophylaxis. Methods: Rabbit eyes were injected subconjunctivally with a combination of triamcinolone and ciprofloxacin hydrochloride, 2 mg/0.1 mL, or ciprofloxacin hydrochloride, 2 mg/0.1 mL, alone. The aqueous and vitreous humor pharmacokinetic profiles were compared with those of a single drop of ciprofloxacin hydrochloride, 0.3%, 6 times daily. In 45 rabbits, Staphylococcus aureus was injected into the anterior chamber: 15 randomly received 1 drop of ciprofloxacin hydrochloride, 0.3%, every 4 hours during 24 hours; 15 received drops of balanced salt solution; and 15 received a combination of triamcinolone and ciprofloxacin hydrochloride, 2 mg/0.1 mL. After 24 hours, endophthalmitis scores were recorded, aqueous and vitreous humors underwent culture, and histologic analysis was performed. Results: The combined triamcinolone and ciprofloxa-cin treatment allowed higher intraocular levels of ciprofloxacin. The median endophthalmitis clinical scores for the combination of triamcinolone and ciprofloxacin and ciprofloxacin-only eyedrop groups were equivalent (P =.42) and were significantly lower than those of the balanced salt solution group (PϽ.001). The culture was negative for S aureus in the combined triamcinolone and ciprofloxacin and ciprofloxacin eyedrop regimens. No adverse effects were observed with either route. Conclusions: Ciprofloxacin eyedrops and combined triamcinolone and ciprofloxacin were equally tolerated and efficacious. The combined triamcinolone and ciprofloxacin treatment may eliminate noncompliance issues and may prove to be a valuable clinical tool for surgical prophylaxis. Clinical Relevance: The combined triamcinolone and ciprofloxacin treatment may be a new useful strategy for surgical prophylaxis.

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A Single Intraoperative Sub-Tenon’s Capsule Injection of Triamcinolone and Ciprofloxacin in a Controlled-Release System for Cataract Surgery

Abstract: One injection of DuoCat had a therapeutic response and ocular tolerance that were equivalent to conventional eye drops in controlling inflammation after cataract surgery. (ClinicalTrials.gov number, NCT00431028.).

Cited by 26 publications

References 42 publications

Trans-Scleral Controlled-Release of Drugs for Cataract Surgery

Trans-Scleral Controlled-Release of Drugs for Cataract Surgery

The role of Dexamethasone in clinical pharmaceutical treatment for patients with cataract surgery

Subconjunctival Delivery of Antibiotics in a Controlled-Release System

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