Take-home: Examining how utilizing an intravitreal transzonular injection can help patient compliance.
Crossville, TN—Intravitreal transzonular antiobiotic/steroid combination concurrent with cataract surgery can provide a “significant benefit with minimum risk,” said M. Stewart Galloway, MD, Cumberland Eye Care, Crossville, TN.
Trimoxi (intravitreal triamcinolone/moxifloxacin, Imprimis Pharmaceuticals) following phacoemulsification with IOL implantation “is able to prevent postoperative inflammation, cystoid macular edema (CME), and endophthalmitis,” said Dr. Galloway, Cumberland Eye Care (Tenn.).
It is common practice to deliver antibiotics topically, but with Trimoxi, the delivery is transzonular. Trimoxi is compounded, preservative-free triamcinolone acetonide and moxifloxacin delivered 15 mg/1mg/ml, with 0.2 ml injected transzonularly into the anterior vitreous, Dr. Galloway said, resulting in a total drug delivery of 3 mg triamcinolone and 0.2 mg of moxifloxacin.
“After the lens implant is in place, and prior to removing viscoelastic, you pass a cannula through the incision, over the anterior capsule, underneath the iris, and then penetrate the zonules into the anterior vitreous so the drug is delivered into the vitreous itself,” Dr. Galloway said.
Unlike intracameral injections, which go into the anterior chamber, Trimoxi is designed to be delivered to the posterior chamber, directly into the vitreous, he said.