Dropless vitrectomy with suprachoroidal triamcinolone-moxifloxacin

(Image credit: AdobeStock/Drazen)

K. Chalam MD, PhD, MBA, FRCS(C), FASRS, presented, “Dropless vitrectomy with suprachoroidal triamcinolone-moxifloxacin: A comparative analysis of safety and efficacy with standard-of-care topical drops” at the 2025 annual scientific meeting of the American Society of Retina Specialists. This meeting took place from July 30 through August 2, 2025. Chalam gave this presentation on Friday, August 1, 2025, during the Surgical Techniques Symposium 2. Chalam is a part of the Loma Linda University Eye Institute in Loma Linda, California.

The objective of this research was to evaluate if a single suprachoroidal intraoperative (trimoxi) triamcinolone acetonide–moxifloxacin injection without postoperative drops could effectively control inflammation after vitreous surgery and demonstrate that it was not inferior to standard drop therapy.

What was the study design?

The study was retrospective longitudinal comparative case. Electronic medical records of patients who underwent vitrectomy with a single suprachoroidal injection of 0.3 cc of triamcinolone acetonide–moxifloxacin with custom made 34 G 1 mm needle (Group 1) were reviewed and compared with those of patients who received a standard postoperative topical regimen of tapering doses of steroid-antibiotic eye drops (Group 2). Outcomes assessed included intraocular inflammation, corneal edema, visual acuity, incidence of postoperative infection and the incidence of elevated IOP at postoperative days 1, 42 (6 weeks), and 90 (3 months).The study included 122 eyes of 122 patients (61 eyes per group).

What were the study results?

• At 6 weeks and 90 days postoperatively, anterior chamber cell reaction severity decreased by 22.0% and 24.0%, respectively, in the suprachoroidal injection group compared with the standard eye drop group (P < .001 and P < .02, respectively).
• The best-corrected distance visual acuity improved by approximately 3 lines in both groups at 90 days (P < .001).
• Corneal edema was significantly more severe in Group 2 on postoperative day 1 (odds ratio, 1.16; P < .001). No statistically significant differences were observed at 6 weeks or 90 days (P = .22 and P = .38, respectively).
• The incidence of elevated IOP did not differ significantly between groups at any postoperative time point.
• No cases of endophthalmitis were reported.

With these results, the researchers concluded that suprachoroidal triamcinolone acetonide–moxifloxacin injection (dropless vitrectomy) effectively controlled intraocular inflammation following vitrectomy surgery. It is noninferior to standard topical therapy, and is a viable alternative, particularly for patients with poor adherence to postoperative eye drop regimens.

Reference

1. Chalam K. August 1, 2025. Dropless vitrectomy with suprachoroidal triamcinolone-moxifloxacin: A comparative analysis of safety and efficacy with standard-of-care topical drops. American Society of Retina Specialists 2025 (ASRS), Long Beach, California, USA.