Efficacy and safety of dropless cataract surgery

Abstract

Purpose: To evaluate the clinical outcome following intraoperative transzonular intravitreal injection of triamcinolone acetonide and moxifloxacin in patients undergoing phacoemulsification cataract extraction with intraocular lens (IOL) implantation. Methods: In this prospective, non-randomized, clinical, interventional study, a total of 200 eyes were enrolled. Patients who voluntarily gave their consent after being informed about dropless cataract surgery along with its pros and cons were included. Those who had glaucoma or were known steroid responders as well as those who were lost to follow-up were excluded. 0.1 ml each of moxifloxacin (500 mg) and triamcinolone acetonide (4 mg) were injected transzonularly following IOL implantation in phacoemulsification cataract surgery with the help of 27G curved cannula. Slit-lamp examination was done to detect cells, visual acuity was noted, and intraocular pressure was measured postoperatively on day 1, 7, 30, 60, and 90. Results: Uncorrected visual acuity (UCVA) greater than 6/9 was achieved in 96% of patients at the end of 3 months. The mean IOP was found to be normal in all the cases at every visit. Twenty patients complained of floaters on postoperative day 1 (D1), which decreased to zero after 60 days (D60). None of the patients needed any eye drop during the entire postoperative period. Conclusion: The study demonstrates that this procedure is advantageous and safe.

Same-Day versus Next-Day Dexamethasone Intracanalicular Insert Administration for Inflammation and Pain Control Following Cataract Surgery: A Retrospective Analysis

“…This approach-utilizing intracameral antibiotics and sustained-release steroid products-has been advocated by multiple surgeons as an important step forward in optimizing therapeutic efficacy and postoperative quality of life in patients undergoing the most commonly performed outpatient surgery in adults in the United States. [10][11][12][13] Replacing self-administered topical therapy with surgeonadministered therapy reduces risks associated with improper instillation technique and eliminates nonadherence, resulting in better efficacy, safety, and quality of life outcomes. These attributes of sustained dexamethasone delivery with the intracanalicular insert are valued by both physicians and patients.…”

“…9 Multiple large-scale studies of intracameral antibiotics at the end of surgery have challenged the necessity of postoperative topical antibiotics, and the recent commercialization of 2 sustained-release formulations of dexamethasone-an intracanalicular insert containing dexamethasone (Dextenza (Dextenza, Ocular Therapeutix, Bedford, MA) and an intraocular dexamethasone suspension (Dexycu, dexamethasone 517 µg, EyePoint Pharmaceuticals, Watertown, MA)-has similarly challenged the need for topical dosing of corticosteroids postoperatively, leading many surgeons to propose a paradigm shift to dropless cataract surgery. [10][11][12][13] The intracanalicular insert is a polyethylene glycol hydrogel rod impregnated with 0.4 mg of preservativefree dexamethasone, conjugated with fluorescein for visualization, that is inserted through the punctum into the inferior or superior canaliculus. Upon hydration, the insert swells and self-anchors, dissolving over time with sustained and tapered delivery of dexamethasone for up to 30 days.…”

Same-Day Versus Next-Day Dexamethasone Intracanalicular Insert Administration for Inflammation and Pain Control Following Cataract Surgery: A Retrospective Analysis

“…This approach-utilizing intracameral antibiotics and sustained release steroid products-has been advocated by multiple surgeons as an important step forward in optimizing therapeutic e cacy and postoperative quality of life in patients undergoing the most commonly performed outpatient surgery in adults in the United States. [10][11][12][13] Replacing self-administered topical therapy with surgeon-administered therapy reduces risks associated with improper instillation technique and eliminates nonadherence, resulting in better e cacy, safety, and quality of life outcomes.…”

“…9 Multiple large-scale studies of intracameral antibiotics at the end of surgery have challenged the necessity of postoperative topical antibiotics, and the recent commercialization of 2 sustained-release formulations of dexamethasone-an intracanalicular insert containing dexamethasone (Dextenza, (Dextenza, Ocular Therapeutix, Bedford, MA) and an intraocular dexamethasone suspension (Dexycu, dexamethasone 517 µg, EyePoint Pharmaceuticals, Watertown, MA)-has similarly challenged the need for topical dosing of corticosteroids postoperatively, leading many surgeons to propose a paradigm shift to dropless cataract surgery. [10][11][12][13] The intracanalicular insert is a polyethylene glycol hydrogel rod impregnated with 0.4 mg of preservativefree dexamethasone, conjugated with uorescein for visualization, that is inserted through the punctum into the inferior or superior canaliculus. Upon hydration, the insert swells and self-anchors, dissolving over time with sustained and tapered delivery of dexamethasone for up to 30 days.…”

Comparison between 0.1% Nepafenac and 1% Prednisolone Eye Drop in Postoperative Management Following Micro-incisional Cataract Surgery

“…Phacoemulsification remains one of the most commonly performed elective surgical procedure worldwide [ 1 ]. The improved surgical methods and newer instruments have significantly decreased the surgical complications, and have been able to increase the expectation level of a successful visual outcome [ 2 , 3 ]. Anterior segment inflammation is regarded as one of the most commonly occurred complications following phacoemulsification.…”