Comparative analysis of intravitreal triamcinolone acetonide–moxifloxacin versus standard perioperative eyedrops in cataract surgery

Nassiri, Saman; Hwang, Frank S.; Kim, Jason; LeClair, Bronson; Yoon, Eden; Pham, Michael; Rauser, Michael

doi:10.1016/j.jcrs.2018.12.019

Cited by 19 publications

(22 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, studies have shown that the injection of low-dose triamcinolone acetonide up to 3 mg has a lower incidence of IOP spikes than those seen with postoperative eye drops 9 . In line with our study, Nassiri et al did not nd a difference in IOP between Tri-Moxi and standard topical therapy groups after cataract surgery 10 . Various topical steroid agents may also cause steroid responses at varying rates depending on the speci c steroid agent used.…”

Section: Discussionsupporting

confidence: 92%

Efficacy and Safety of ‘Dropless Vitrectomy Surgery’ and Comparison of Outcomes to Standard of Care Topical Therapy

Chalam

Ahmed²

2023

Preprint

View full text Add to dashboard Cite

Objective/Background: To compare the effectiveness of intravitreal injection of triamcinolone acetonide/moxifloxacin (Tri-Moxi) with the standard eye drop regimen for controlling postoperative inflammation, intraocular pressure, infections, macular thickness, and visual acuity (VA) in patients undergoing pars plana vitrectomy for various retinal disorders. Subject/Methods: In this retrospective longitudinal study, patients who underwent vitrectomy using intravitreal Tri-Moxi at the end of surgery (Group 1) were compared with those who received standard topical steroid antibiotics (Group 2) in terms of intraocular inflammation, intraocular pressure, and macular thickness based on optical coherence tomography. Results In total, 162 consecutive eyes (group 1 [81 eyes]; group 2 [82 eyes]) were included. VA improved by two lines in both groups at 90 days. In Group 1, preoperative VA (logMAR) was 0.92 (0.66) compared to 0.92 (0.75) in group 2 (p = 1), while at 3 months it was 0.61 (0.3) and 0.57 (0.3), respectively (p = 0.46). Group 1 showed superior outcomes with regard to central foveal thickness. The average central foveal thickness CFT ( µm) in group 1 preoperatively was 423 (95) and 348 (63) at 3 months compared to group 2 526 (109) and 306 (108) preoperatively and 3 months, respectively (p = 0.042). There was no statistically significant difference in the rate of elevated intraocular pressure between the two groups, and no cases of endophthalmitis were observed in either group. Conclusions Tri-Moxi is effective after vitrectomy and is not inferior to standard postoperative topical therapy.

show abstract

Section: Discussionsupporting

confidence: 92%

Efficacy and Safety of ‘Dropless Vitrectomy Surgery’ and Comparison of Outcomes to Standard of Care Topical Therapy

Chalam

Ahmed²

2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Though great visual outcomes are the primary endpoint for patients and surgeons, postoperative inflammation and microbial infection remain an overarching concern as they can lead to suboptimal or even devastating outcomes, notably postoperative infectious endophthalmitis. Citing ocular surface toxicity, high expenses, unpredictable effective dose delivery, poor compliance, and administration of topical eye drops, there has been a growing interest and acceptance of “dropless” or “less drops” alternatives [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…e recent advent of intravitreal triamcinolone acetonide-moxifloxacin (Tri-Moxi), composed of 1.5% triamcinolone acetonide and 0.1% moxifloxacin, offers one option for endophthalmitis prophylaxis. Recent studies have demonstrated triamcinolone acetonide-moxifloxacin as an effective modality for controlling intraocular inflammation after cataract surgery compared to a standard topical eyedrop regimen [3]. Another option used by surgeons in the US is intracameral dexamethasone-moxifloxacin-ketorolac (Dex-Moxi-Ketor), which is composed of 0.1% dexamethasone, 0.05% moxifloxacin, and 0.04% ketorolac.…”

Section: Introductionmentioning

confidence: 99%

Comparative Outcomes of Standard Perioperative Eye Drops, Intravitreal Triamcinolone Acetonide-Moxifloxacin, and Intracameral Dexamethasone-Moxifloxacin-Ketorolac in Cataract Surgery

Kuriakose

Cho

Nassiri

et al. 2022

Journal of Ophthalmology

Self Cite

View full text Add to dashboard Cite

Background. Since the advent of cataract surgery, topical eye drops have been the mainstay of postoperative prophylaxis and treatment. Due to factors such as high expenses and poor patient compliance, there has been a growing interest and acceptance of “dropless” or “less drops” alternatives. The purpose of this study is to compare the effectiveness of intravitreal triamcinolone acetonide-moxifloxacin and intracameral dexamethasone-moxifloxacin-ketorolac to a standard eye drop regimen in controlling postoperative inflammation, corneal edema, and intraocular pressure (IOP) among cataract patients. Methods. A retrospective longitudinal comparative study among 619 consecutive eyes receiving either a standard eye drop regimen, intraoperative triamcinolone acetonide-moxifloxacin, or dexamethasone-moxifloxacin-ketorolac was performed between October 2016 and December 2020. Primary endpoints at postoperative day one (POD1), week one (POW1), and month one (POM1) included corneal edema, anterior chamber inflammation (ACI), and IOP. Results. Throughout the postoperative time points, there were no significant differences in corneal edema between intravitreal triamcinolone acetonide-moxifloxacin versus the standard eye drop therapy (OR [95% CI]: 1.09 [0.82, 1.45], P = 0.54 ) and intracameral dexamethasone-moxifloxacin-ketorolac versus the standard eye drop treatment (OR [95% CI]: 1.22 [0.89, 1.67], P = 0.22 ). The postoperative ACI severity was lower in the dexamethasone-moxifloxacin-ketorolac group than in the triamcinolone acetonide-moxifloxacin group by 35% on postoperative day 1 ( P = 0.01 ). The differences at subsequent postoperative time points were not statistically significant ( P = 0.27 and P = 1.00 for POW1 and POM1, respectively). IOP at POM1 follow-up visit was statistically significantly higher for the triamcinolone acetonide-moxifloxacin group (mean (±SD): 15.64 (4.26)) than the dexamethasone-moxifloxacin-ketorolac (mean (±SD): 14.16 (4.02)) ( P < 0.01 ). There was no statistical difference in rates of CME ( P = 0.16 ), and there were no cases of endophthalmitis. Conclusions. Intravitreal triamcinolone acetonide-moxifloxacin and intracameral dexamethasone-moxifloxacin-ketorolac demonstrate similar levels of efficacy to a standard eye drop regimen after cataract surgery. This study reinforces them as viable alternatives to traditional postoperative drops.

show abstract

“…Though great visual outcomes are the primary endpoint for patients and surgeons, postoperative in ammation and microbial infection remain an overarching concern as they can lead to suboptimal or even devastating outcomes, notably postoperative infectious endophthalmitis. Citing ocular surface toxicity, high expenses, unpredictable effective dose delivery, poor compliance and administration of topical eye drops, there has been a growing interest and acceptance of "dropless" alternatives [3,4] The European Society of Cataract and Refractive Surgeons (ESCRS) Endophthalmitis Study Group published a landmark study in 2007 demonstrating that the risk of infectious postoperative endophthalmitis was reduced by nearly 5-fold (0.34-0.07%) through the use of perioperative intracameral cefuroxime [5]. In another study, the rate of endophthalmitis was reported to be 0% in 25,920 subjects given intracameral antibiotics compared to other delivery methods [6].…”

Section: Introductionmentioning

confidence: 99%

“…Recent studies have demonstrated triamcinolone acetonide-moxi oxacin as an effective modality for controlling intraocular in ammation after cataract surgery compared to a standard topical eyedrop regimen. 3 Another option used by surgeons in the US is intracameral dexamethasone-moxi oxacinketorolac (Dex-Moxi-Ketor), which is composed of 0.1% dexamethasone, 0.05% moxi oxacin, and 0.04% ketorolac. This compound is unique in that the preparation is clear, which prevents the transient blurring patients may experience with opaque preparations such as triamcinolone acetonide-moxi oxacin.…”

Section: Introductionmentioning

confidence: 99%

Comparative Outcomes of Standard Perioperative Eye Drops, Intravitreal Triamcinolone Acetonide-Moxifloxacin, and Intracameral Dexamethasone-Moxifloxacin-Ketorolac in Cataract Surgery

Kuriakose

Cho

Nassiri

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

Background: Since the advent of cataract surgery, topical eye drops have been the mainstay of postoperative prophylaxis and treatment. Due to factors such as high expenses and poor patient compliance, there has been a growing interest and acceptance of “dropless” alternatives. The purpose of this study is to compare the effectiveness of intravitreal triamcinolone acetonide-moxifloxacin and intracameral dexamethasone-moxifloxacin-ketorolac to a standard eye drop regimen in controlling postoperative inflammation, corneal edema, and intraocular pressure (IOP) among cataract patients.Methods: A retrospective longitudinal comparative study among 619 consecutive eyes receiving either a standard eye drop regimen, intraoperative triamcinolone acetonide-moxifloxacin or dexamethasone-moxifloxacin-ketorolac was performed between October 2016 and December 2020. Primary endpoints at postoperative day one (POD1), week one (POW1), and month one (POM1) included corneal edema, anterior chamber inflammation (ACI), and IOP.Results: Throughout the postoperative time points, there were no significant differences in corneal edema between intravitreal triamcinolone acetonide-moxifloxacin versus the standard eye drop therapy (OR [95%CI]: 1.09 [0.82, 1.45], P = .54) and intracameral dexamethasone-moxifloxacin-ketorolac versus the standard eye drop treatment (OR [95% CI]: 1.22 [0.89, 1.67], P = .22). The postoperative ACI severity was lower in the dexamethasone-moxifloxacin-ketorolac group compared to the triamcinolone acetonide-moxifloxacin group by 35% on postoperative day 1 (P = .01). The differences at subsequent postoperative time points were not statistically significant (P = .27 and P = 1.00 for POW1 and POM1 respectively). IOP at POM1 follow up visit was statistically significantly higher for the triamcinolone acetonide-moxifloxacin group [mean (±SD): 15.64 (4.26)] compared to the dexamethasone-moxifloxacin-ketorolac [mean (±SD): 14.16 (4.02)] (P < .01). There was no statistical difference in rates of CME (P = .16) and there were no cases of endophthalmitis.Conclusions: Intravitreal triamcinolone acetonide-moxifloxacin and intracameral dexamethasone-moxifloxacin-ketorolac demonstrate similar levels of efficacy to a standard eye drop regimen after cataract surgery. This study reinforces them as viable alternatives to traditional postoperative drops.

show abstract

Comparative analysis of intravitreal triamcinolone acetonide–moxifloxacin versus standard perioperative eyedrops in cataract surgery

Cited by 19 publications

References 33 publications

Efficacy and Safety of ‘Dropless Vitrectomy Surgery’ and Comparison of Outcomes to Standard of Care Topical Therapy

Efficacy and Safety of ‘Dropless Vitrectomy Surgery’ and Comparison of Outcomes to Standard of Care Topical Therapy

Comparative Outcomes of Standard Perioperative Eye Drops, Intravitreal Triamcinolone Acetonide-Moxifloxacin, and Intracameral Dexamethasone-Moxifloxacin-Ketorolac in Cataract Surgery

Comparative Outcomes of Standard Perioperative Eye Drops, Intravitreal Triamcinolone Acetonide-Moxifloxacin, and Intracameral Dexamethasone-Moxifloxacin-Ketorolac in Cataract Surgery

Contact Info

Product

Resources

About