Novel Postoperative Dropless Protocol for Micro-Incision Vitrectomy Surgery

• Published in: Ophthalmic surgery, lasers & imaging Vol. 52; no. 11; pp. 587 - 591
• Main Authors: Brown, Gordon T, Karth, Peter A, Hunter, Allan A
• Format: Journal Article
• Language: English
• Published: United States Slack, Inc 01.11.2021; SLACK INCORPORATED
• Subjects: Anterior Chamber; Antibiotics; Antimicrobial agents; Cataracts; Cost control; Dexamethasone; Disease prevention; Endophthalmitis - etiology; Eye surgery; Humans; Inflammation; Intraocular pressure; Medical research; Medicine, Experimental; Neomycin; Patient compliance; Postoperative Complications; Postoperative period; Retinal detachment; Retrospective Studies; Surgeons; Surgery; Surgical outcomes; Visual Acuity; Vitrectomy - methods
• ISSN: 2325-8160; 2325-8179
• DOI: 10.3928/23258160-20211014-01

To evaluate the outcomes of a novel postoperative dropless protocol for 25-gauge and 27-gauge micro-incision vitrectomy surgery (MIVS). 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. 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 ( = 0.004). Mean intraocular pressure increased from 14.5 (±4.3) to 15.5 (±4.8) postoperatively ( < 0.001). Mean follow-up was 96 days. 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. .