Dropless Punctal Plug Dexamethasone, Intracameral Ketorolac and Moxifloxacin Compared to Conventional Topical Therapy in Cataract Surgery. | ASCRS
Presentation
Dropless Punctal Plug Dexamethasone, Intracameral Ketorolac and Moxifloxacin Compared to Conventional Topical Therapy in Cataract Surgery.
May 2020
Meeting: 2020 Virtual Annual Meeting
Session: SPS-111 Cataract Surgery - Medications
Authors: Eric D. Donnenfeld, MD, John Hovanesian MD, Chad Hummel MD, Jose Quintero MD
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Purpose
To evaluate the safety and ocular efficacy of dropless Dextenza, Omidria, and intracameral moxifloxacin in controlling post-operative ocular pain, inflammation and infection associated with cataract surgery. Efficacy and compliance of dropless therapy will be compared to conventional topical medications.

Methods
This is a randomized, self-controlled prospective clinical study. Patients undergoing bilateral sequential cataract surgery will be randomized to receive two treatment groups, dropless Dextenza, Omidria, and intracameral moxifloxacin (experimental) and moxifloxacin 0.5% qid, ketorolac 0.5% qid, and prednisolone acetate 1% qid topical drops (control). Patient preference, pain, complications, and clinical outcomes will be evaluated.

Results
The experimental dropless group and the control topical medication group had no significant difference in improvement in cell and flare, postoperative pain, best corrected visual acuity, or macula thickness at 2 weeks, 1 month and 2 months. There were no cases of endophthalmitis or CME in either group. Two patients in the dropless group required rescue topical corticosteroids. 6 patients in the topical medication study developed significant superficial punctate keratitis (SPK) and no patients in the dropless group developed SPK. Patient preference was significantly higher for dropless medications than topical medications (p < 0.01).

Conclusion
Dropless Dextenza, Omidria, and intracameral moxifloxacin, are a safe and effective alternative to topical medications to reduce pain, inflammation and infection following cataract surgery. Puntal plug non-preserved corticosteroids may improve the ocular surface as compared to topical preserved corticosteroids, antibiotics and NSAIDs.
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This presentation is from the session "SPS-111 Cataract Surgery - Medications" from the 2020 ASCRS Virtual Annual Meeting held on May 16-17, 2020.

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