Singhal Rishi, Luo Andrew, O'Rourke Tara, Scott Ingrid U, Pantanelli Seth M
Department of Ophthalmology and Penn State College of Medicine, Hershey, Pennsylvania.
Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania.
J Ocul Pharmacol Ther. 2019 Dec;35(10):565-570. doi: 10.1089/jop.2019.0097. Epub 2019 Oct 15.
To compare the safety and efficacy of an intraoperative transzonular injection of triamcinolone-moxifloxacin (Imprimis' Tri-Moxi 15 mg/1 mg/mL) to topical drops in patients undergoing cataract surgery. Between January 2017 and October 2017, patients undergoing phacoemulsification cataract surgery by a single surgeon at the Penn State Eye Center were offered a single intraoperative injection of transzonular triamcinolone-moxifloxacin in lieu of perioperative drops. Between November 2017 and July 2018, the transzonular injection was not offered, and all patients who underwent surgery by the same surgeon received a drop regimen consisting of polymyxin b/trimethoprim and prednisolone acetate 1%. Patients were seen 1 day, 1 week, and 6-9 weeks postoperatively. Outcome measures included incidence of intraoperative complications, postoperative breakthrough inflammation, cystoid macular edema, and infectious sequela. Of the 198 eyes, 99 from 73 patients received the injection and 99 from 82 patients received topical drops. One (1%) intraoperative posterior capsule tear occurred in each group. Eleven (11.1%) eyes in the injection group and 3 (3%) in the drop group experienced symptomatic breakthrough inflammation necessitating treatment ( = 0.0488). One (1%) eye in the injection group and zero (0%) in the drop group developed clinically significant macular edema ( = 1.0). No instances of elevated intraocular pressure or infectious sequela occurred in either group ( = 1.0). Transzonular injection of triamcinolone-moxifloxacin may be associated with an increased incidence of breakthrough inflammation compared to topical drops.
比较白内障手术患者术中经晶状体悬韧带注射曲安奈德-莫西沙星（英普利米斯公司的曲安奈德-莫西沙星15毫克/1毫克/毫升）与局部滴眼剂的安全性和有效性。2017年1月至2017年10月期间，宾夕法尼亚州立大学眼科中心由同一位外科医生进行超声乳化白内障手术的患者，被提供单次术中经晶状体悬韧带注射曲安奈德-莫西沙星，以替代围手术期滴眼剂。2017年11月至2018年7月期间，未提供经晶状体悬韧带注射，所有由同一位外科医生进行手术的患者接受了由多粘菌素B/甲氧苄啶和1%醋酸泼尼松组成的滴眼方案。术后1天、1周和6-9周对患者进行检查。观察指标包括术中并发症、术后突破性炎症、黄斑囊样水肿和感染后遗症的发生率。在198只眼中，73例患者的99只眼接受了注射，82例患者的99只眼接受了局部滴眼剂。每组均发生1例（1%）术中后囊膜破裂。注射组有11只眼（11.1%）和滴眼剂组有3只眼（3%）出现有症状的突破性炎症，需要治疗（P = 0.0488）。注射组有1只眼（1%）发生具有临床意义的黄斑水肿，滴眼剂组为零（0%）（P = 1.0）。两组均未出现眼压升高或感染后遗症的情况（P = 1.0）。与局部滴眼剂相比，经晶状体悬韧带注射曲安奈德-莫西沙星可能与突破性炎症发生率增加有关。
