Intraocular Lens Soaking in Lieu of Intravitreal Medications for Cataract Surgery Without Eyedrops
Purpose
To determine optic clarity and clinical results after a hydrophilic IOL is soaked for 15 minutes in proprietary mixture of triamcinolone acetonide, moxifloxacin, and vancomycin before human implantation.
Methods
Prospective, non-randomized pilot study with a treatment (N = 10) and a control (N=10) arm. The treatment arm received implantation of the soaked IOL in the capsular bag with intracameral injection and sub-Tenon injection of triamcinolone alone without intravitreal injections or post-operative eye drops. The control arm received a standard (no soaking) IOL with typical post-operative drops. Optic clarity was graded clinically (at post-op visits day 1, week 1, and month 1) on 0 to 4 scale. Secondary outcome measures included presence of macular thickening on OCT, elevated IOP, or need for rescue medications.
Results
Optic clarity was not affected by soaking the IOL for 15 minutes in the medication mixture. Clarity was maintained throughout postoperative course. Intravitreal injection was not needed for successful cataract surgery without eye drops.
Conclusion
Certain eyes do not lend themselves to intravitreal injection. An IOL soak technique may extend intraocular drug delivery longer than intracameral injection alone without harming optic clarity. Anti-inflammatory activity is aided by depot sub-Tenon steroid.