Findings from a large retrospective study support the efficacy and safety of dropless cataract surgery with transzonular injection of a corticosteroid and fluoroquinolone (Tri-Moxi, Imprimis Pharmaceuticals) for preventing postoperative infection and inflammation, according to Barry Emara, MD.
Aiming to characterize outcomes from his first 1,000 patients, Dr. Emara reviewed outcomes in 1,166 eyes that received a 0.2 mL transzonular injection of triamcinolone acetonide and moxifloxacin hydrochloride at conclusion of cataract surgery. The series included all patients who underwent dropless cataract surgery between February 2016, when he first began using the technique, through September 2018.
Dr. Emara reported that postoperative treatment with a topical corticosteroid was needed by 106 eyes (9.1%), and there were no cases of endophthalmitis. The need for a topical corticosteroid was similar in an updated series that included an additional 221 eyes. In the expanded population, 118 (8.6%) of 1387 eyes required topical corticosteroid treatment, and there were no cases of endophthalmitis.
“Efficacy with topical medications used to prevent infection and inflammation after cataract surgery is challenged by dependence on patient compliance and the need for the active ingredient to penetrate to the target sites,” said Dr. Emara, adjunct professor of ophthalmology, Schulich School of Medicine & Dentistry, Western University, Windsor, Canada. He also operates his private surgical practice out of the Windsor Surgical Centre.
“Challenges often lead to innovation, and the compounded injectable triamcinolone-moxifloxacin formulation address the need for alternatives to topical medications,” he said.
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Barry Emara, MD
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This article is based on a paper presented by Dr. Emara at the 2019 ASCRS Symposium in San Diego, CA. Dr. Emara has no relevant financial interests to disclose.