Evaluating the effect of intravitreal triamcinolone–moxifloxacin during cataract surgery on central macular edema in patients with preexisting diabetic retinopathy

Abstract

Purpose: To evaluate the effect of intravitreal triamcinolone acetonide–moxifloxacin at the time of cataract surgery on central macular edema in patients with preexisting diabetic retinopathy. Setting: Loma Linda University Eye Institute, California, USA. Design: Retrospective observational clinical study. Methods: Retrospective chart review included 75 eyes of 64 patients who had cataract surgery between February 2015 and October 2018 performed by 2 surgeons. Intravitreal injection of triamcinolone–moxifloxacin (15 mg/1 mg/mL, 0.2 mL injection with 3.0 mg triamcinolone acetonide and 0.2 mg moxifloxacin) was given at the time of surgery. Visual acuity and central macular thickness (CMT) with optical coherence tomography were recorded at preoperative and postoperative visits. Results: Mean visual acuity (logarithm of the minimum angle of resolution) at 4 to 6 weeks, 6 to 12 weeks, and 12 weeks or more postoperatively was 0.32, 0.35, and 0.43, respectively. Baseline mean CMT of 75 eyes was 294 μm (SD = 72). Mean CMT 4 to 6 weeks postoperatively for 46 eyes decreased from 299 μm (78) to 297 μm (79), with a mean decrease of 2 μm (50) (P = .97). Mean CMT 6 to 12 weeks postoperatively for 34 eyes increased from 317 μm (88) to 344 μm (111), with a mean increase of 26 μm (98) (P = .021). Mean CMT 12 weeks or more for 60 eyes increased from 295 μm (72) to 328 μm (108), with a mean increase of 33 μm (85) (P = .0023). Conclusions: Triamcinolone acetonide–moxifloxacin maintained stability of postoperative CMT in patients undergoing cataract surgery with preexisting diabetic retinopathy in the short term, with the greatest effect at 4 to 6 weeks postoperatively.

Management of inflammation after the cataract surgery

“…In an observational clinical study carried out by Angkadjaja et al , Tri-Moxi was injected after phacoemulsification for patients with preexisting diabetic retinopathy. They have found that this drug was effective in a short term – CMT decreased when measured 4 weeks after the cataract surgery but mean CMT 6–12 weeks postoperatively for 34 eyes increased with a mean increase of 26 μm ( P = 0.021) [114].…”