Transzonular intravitreal injection eases treatment burden after cataract surgery
Compounded formulation prevents infection, inflammation, cystoid macular edema
Administration of a transzonular intravitreal injection of a compounded formulation of a steroid and two antibiotics was shown to have similar effects regarding infection and inflammation rates compared with the standard instillation of topical drugs after cataract surgery.
An added benefit was the elimination of concern regarding patient compliance with the postoperative regimen. This formulation might be considered as an alternative to patient instillation of topical drugs postoperatively to prevent infection, inflammation, and cystoid macular edema (CME).
The rationale behind this formulation, according to the study investigators, was “the design of [this formulation] as a single-use intraoperative prophylactic is thought to decrease both [the] patient and surgeon burden by alleviating the need for complicated postoperative eye drop regimens.”
A number of complications, although rare, always can develop after cataract surgery, including persistent inflammation, CME, and endophthalmitis, and prophylactic therapies are prescribed to drive the risk to the lowest levels possible.
However, as with all drugs, there are associated safety concerns with the prophylactic medications.
In addition, patient compliance is always an issue because of the drug costs, the number of drugs prescribed, the complexity of the regimen, as well as the patients’ instillation skills.
These problems, according to Sydney L. Tyson, MD, MPH, underscore the need for a prophylactic regimen that is easier, “ . . . one that reduces or eliminates the patient burden of postoperative eye drops while remaining as safe and effective” as the standard of postoperative care.
Intracameral injections have been tried to meet these needs and are indeed safe and effective, prevent postoperative inflammation, and do not significantly increase the IOP. However, this route of administration can facilitate access of the drugs to the posterior segment.
In contrast, intravitreal injections of drugs are advantageous in that they can result in high concentrations of drugs intraocularly that persist in the eye for up to 3 months and reach most ocular tissues.