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Novel Postoperative Dropless Protocol for Micro-Incision Vitrectomy Surgery
Background And Objective:
To evaluate the outcomes of a novel postoperative dropless protocol for 25-gauge and 27-gauge micro-incision vitrectomy surgery (MIVS).
Patients And Methods:
The institutional review board approved a single-center, retrospective study. A total of 493 surgeries were identified, and 451 cases from 369 patients met eligibility criteria. Instead of pre- or postoperative drops, patients were given a novel postoperative dropless protocol consisting of subconjunctival injections of a 1:1 cefazolin:dexamethasone mix at each sclerotomy and intravitreally, and injection of posterior sub-Tenon's Kenalog. Primary outcome measure was cases of postoperative endophthalmitis.
Results:
There was one presumed case of endophthalmitis. Anterior chamber paracentesis sample was negative for culture and Gram stain. For all patients, mean logMAR best-corrected visual acuity improved from 0.65 (±0.69) to 0.57 (±0.61) postoperatively (P = 0.004). Mean intraocular pressure increased from 14.5 (±4.3) to 15.5 (±4.8) postoperatively (P < 0.001). Mean follow-up was 96 days.
Conclusion:
This novel postoperative dropless protocol could potentially be a convenient alternative to topical eye drops for patients undergoing MIVS, but further study is required to establish its safety. [.
Insights
A new dropless protocol using injections for micro-incision vitrectomy surgery (MIVS) showed promising results. While visual acuity improved and endophthalmitis was rare, further research is needed to confirm the safety of this dropless approach.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Retinal Surgery
Background:
- Micro-incision vitrectomy surgery (MIVS) often requires topical postoperative eye drops.
- Managing postoperative eye drop regimens can be challenging for patients.
Purpose of the Study:
- To evaluate the outcomes of a novel dropless protocol for patients undergoing MIVS.
- To assess the safety and efficacy of subconjunctival and intravitreal injections as an alternative to topical drops.
Main Methods:
- A retrospective, single-center study of 451 MIVS cases.
- Patients received subconjunctival cefazolin:dexamethasone and posterior sub-Tenon's Kenalog injections postoperatively.
- Primary outcome was postoperative endophthalmitis; visual acuity and intraocular pressure were also monitored.
Main Results:
- One presumed case of endophthalmitis with negative cultures.
- Mean best-corrected visual acuity improved postoperatively (P = 0.004).
- Mean intraocular pressure showed a slight increase postoperatively (P < 0.001).
Conclusions:
- The novel dropless protocol may offer a convenient alternative for MIVS patients.
- Further investigation is necessary to establish the long-term safety of this dropless regimen.
