Novel Triamcinolone Acetonide-Loaded Liposomal Topical Formulation Improves Contrast Sensitivity Outcome After Femtosecond Laser-Assisted Cataract Surgery

Abstract

Purpose: To assess visual results, macular modifications, and the incidence of clinically significant macular edema (CSME) in patients using a topical triamcinolone acetonide-loaded liposomal formulation (TA-LF) after femtosecond laser-assisted cataract surgery (FLACS). Methods: Fifty-six eyes after FLACS were selected. Twenty-eight eyes in the combined therapy group (P + N) were treated with prednisolone 1% and nepafenac 0.1% for 21 days postoperatively, whereas 28 eyes in the TA-LF group received a liposomal formulation containing 2 mg/mL of TA (0.2%) for the same period of time. Follow-up visits at 1 day, 6 weeks, and 12 weeks after surgery consisted of visual acuity, contrast sensitivity (CS), central foveal thickness (CFT), total macular volume (TMV) measurements, and the detection of CSME. Results: CS improved in the TA-LF group (basal value: 1.087-0.339 vs. 1.276-0.147 at week 12, P = 0.0346), whereas in the P + N group, CS was not different from the baseline (basal value: 1.130-0.331 vs. 1.274-0.133 at week 12, P = 0.1276). There were similar increases in postoperative CFT and TMV in both groups. CFT and TMV significantly correlate with CS only in the TA-LF group. The r 2 for CFT and CS was 0.1963 (P = 0.0206), whereas the r 2 for TMV and CS was 0.3615 (P = 0.0007) at 12 weeks. No difference was observed in the incidence of CSME between the groups. Conclusion: TA-LF is associated with better CS outcomes compared to combined therapy after FLACS.

Safety and Tolerability of Topical Ophthalmic Triamcinolone Acetonide-Loaded Liposomes Formulation and Evaluation of Its Biologic Activity in Patients with Diabetic Macular Edema

“…Among these, topical liposomes (LPs) are one of the most promising strategies [ 19 ]. In fact, LPs constitute the only topical system to deliver TA into the vitreous area with clinical evidence of its effectiveness [ 20 , 21 , 22 ]. The vesicle composition of LPs share almost an indistinguishable outer structure with the cell membrane, conferring its ability to transport either hydrophilic or lipophilic drugs.…”

<p>Cystoid Macular Edema Following Cataract Surgery with Low-Energy Femtosecond Laser versus Conventional Phacoemulsification</p>

“…Despite such advancements, development of pseudophakic cystoid macular edema (PCME) in some cases is the most common cause of unexpected vision loss after uneventful surgery in patients without risk factors. [1][2][3][4][5] Although the pathogenesis of PCME is not fully understood, it is mainly attributed to intraocular inflammation arising from surgical tissue manipulation and thermal damage due to the heat generated from the ultrasonic waves during phacoemulsification. 6 The introduction of the femtosecond laser (FL) to create corneal incisions, capsulorhexis, and perform nuclear fragmentation has contributed to a reduction in ultrasound energy and time required for phacoemulsification, with corresponding reductions in postoperative inflammation, [7][8][9][10][11][12] as is evident from the reduction in anterior-chamber flare following FL-assisted cataract surgery (FLACS).…”

“…6 The introduction of the femtosecond laser (FL) to create corneal incisions, capsulorhexis, and perform nuclear fragmentation has contributed to a reduction in ultrasound energy and time required for phacoemulsification, with corresponding reductions in postoperative inflammation, [7][8][9][10][11][12] as is evident from the reduction in anterior-chamber flare following FL-assisted cataract surgery (FLACS). 4,[13][14][15] As such, it was expected that laser pretreatment may potentially reduce the risk of postoperative PCME.…”

Therapies Based on Nanoparticles for Eye Drug Delivery

“…Liposomes became the first nanomedicines in US Food and Drug Administration (FDA) clinical trials [41]. Interventional clinical trials are summarized in Table 2 according to status (recruiting; enrolling by invitation; active, not recruiting; or completed) [37,38,42].…”

“…Twelve eyes with refractory pseudophakic cystoid macular edema (PCME) were treated with TA-LF for 90 days, and patients under treatment showed a significant improvement in visual acuity and in central foveal thickness with no adverse events recorded [ 37 ]. Moreover, TA-LF showed its utility to prevent PCME and significantly improve the contrast sensitivity after femtosecond-laser-assisted cataract surgery [ 37 , 38 ].…”