poster ARVO

1
Methods
A Single Intraoperative Sub-tenons Capsule
Triamcinolone Acetonide and Ciprofloxacin in a
Biodegradable Micro-particule Controlled Release
System (Duocat) Injection for Cataract
Surgery A Minimally Invasive Drop Less Cataract
Surgical Technique Fernando Paganelli, MD 1b
José A. Cardillo, MD 1a, 2 Luiz A. S. Melo Jr,
MD 2David da Rocha Lucena, MD1b Anselmo G.
Oliveira, PharmD, PhD 3Acácio A Souza Filho,
PharmD, PhD 2. From the 1ª Retina Diagnostic and
Treatment Division, 1b Cataract Section,1
Hospital de Olhos Araraquara, Araraquara-SP 2
Federal University of São Paulo, São Paulo-SP
and 3 Department of Pharmacology, UNESP,
Araraquara-SP BRAZIL.
Purpose To compare the potential of a single
intraoperative sub-Tenons capsule injection of
Duo-Cat (25mg triamcinolone acetonide and 2,0 mg
ciprofloxacin in a biodegradable micro-particule
controlled release system, Figure 1) with 1
Prednisolone ciprofloxacin drops in the
treatment of ocular inflammation after cataract
surgery.
Methods A clinical trial was carried out
including 50 patients who underwent
phacoemulsification and intraocular lens
implantation. At the end of the surgery, the
patients received one of the following treatment
(Group A) 25 patients received an intraoperative
sub-Tenons capsule injection of a 1 ml balanced
salt solution and were treated with
prednisolone-ciprofloxacin eye drops instilled
into the operated eye, according to the following
schedule 1 drop 4 times daily (week 1) 3 times
daily (week 2) 2 times daily (week 3) once
daily (week 4) or (Group B) 25 patients treated
with sub-Tenons capsule Duo-Cat injection with
the eye drop vehicle administered to the eye on a
similar schedule. The main outcome measures
included inflammation degree (cell, flare),
intraocular pressure and lack of response to the
anti-inflammatory applied treatment.
Results Duo-Cat has demontrated to have
anti-inflammatory efficacy equivalent to
conventional prednisolone-ciprofloxacin eye drops
in reducing intraocular inflammation, as measured
by clinical methods. On the 14, 28 e 56
postoperative days, the Duo-Cat group showed a
significant lower intraocular pressure (Plt0.01)
than the prednisolone-ciprofloxacin eye drop
group (Table 1 and Figure 2). On the 3, 7 e 14
postoperative days, the prednisolone-ciprofloxacin
group showed a significant lower AC flare score
(Plt0.01) than Duo-Cat group (Table 1 and Figure
2). Duo-Cat was found to be as safe as the
prednisolone-ciprofloxacin eye drops in terms of
adverse effects, changes in visual acuity,
intraocular pressure, and biomicroscopic and
ophthalmoscopic variables.
Conclusions A single intraoperative Duo-Cat
sub-Tenons capsule injection demonstrated a
clinically equivalent therapeutic response and
ocular tolerance to prednisolone-ciprofloxacin
drops in controlling postoperative inflammation
following uncomplicated cataract surgery. This
new approach may anticipate the reality of no
need for postoperative instillation of medication
in the modern cataract surgery era, and merits
further evaluation.