Visual Outcomes and Safety Profile of “Dropless Vitrectomy” for Epiretinal Membranes

Kakarla V Chalam,1 Anny MS Cheng,2– 4 Suzie Gasparian1 1Department of Ophthalmology, Loma Linda University, Loma Linda, CA, USA; 2Department of Ophthalmology, Broward Health, Fort Lauderdale, FL, USA; 3Department of Ophthalmology, Specialty Retina Center, Deerfield Beach, FL, USA; 4Department of Oph...

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Main Authors: Chalam KV, Cheng AMS, Gasparian S
Format: Article
Language:English
Published: Dove Medical Press 2025-06-01
Series:Clinical Ophthalmology
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Online Access:https://www.dovepress.com/visual-outcomes-and-safety-profile-of-dropless-vitrectomy-for-epiretin-peer-reviewed-fulltext-article-OPTH
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author Chalam KV
Cheng AMS
Gasparian S
author_facet Chalam KV
Cheng AMS
Gasparian S
author_sort Chalam KV
collection DOAJ
description Kakarla V Chalam,1 Anny MS Cheng,2– 4 Suzie Gasparian1 1Department of Ophthalmology, Loma Linda University, Loma Linda, CA, USA; 2Department of Ophthalmology, Broward Health, Fort Lauderdale, FL, USA; 3Department of Ophthalmology, Specialty Retina Center, Deerfield Beach, FL, USA; 4Department of Ophthalmology, University of Florida, Gainesville, FL, USACorrespondence: Kakarla V Chalam, Department of Ophthalmology, Loma Linda University, 11370 Anderson St., Suite 1800, Loma Linda, CA, 92354, USA, Tel +1 904 403-2607, Email kakarla.chalam@gmail.comPurpose: To assess the clinical effectiveness and safety of Tri-Moxi intravitreal injection in comparison to standard postoperative topical steroid-antibiotic treatment after epiretinal membrane (ERM) removal with pars plana vitrectomy (PPV).Methods: A retrospective longitudinal cohort study of 278 eyes undergoing ERM removal by PPV was conducted from 2019 to 2023. Group 1 (N = 139) received a triamcinolone acetonide–moxifloxacin (Tri-Moxi) intravitreal injection at the conclusion of surgery, and Group 2 (N = 139) had postoperative standard topical antibiotic-steroid therapy. Clinical changes of best-corrected visual acuity (BCVA), intraocular pressure (IOP), and central foveal thickness (CFT) were evaluated.Results: By 3-month after surgery, the Tri-Moxi (Group 1) demonstrated a significantly greater reduction in CFT (178 ± 32 vs 145 ± 38 μm, P < 0.001) and a slightly superior improvement in BCVA (0.34 ± 0.03 vs 0.41 ± 0.04 logMAR, P < 0.05) compared to the standard (Group 2). Postoperative IOP remained minimal change in both groups. The occurrence of cystoid macular edema was markedly reduced in patients receiving Tri-Moxi (4% vs 10%, P = 0.02). No infection or ocular hypertension cases were recorded.Conclusion: For the postoperative management of PPV in ERM patients, intravitreal Tri-Moxi injection is an efficacious and safe alternative to standard topical therapy. Intravitreal Tri-Moxi can be used as a viable treatment option for managing inflammation and preventing infection after epiretinal membrane removal by pars plana vitrectomy. Tri-Moxi group demonstrated superior anatomical outcomes and comparable functional outcomes while simplifying postoperative care and reducing the occurrence of cystoid macular edema compared to standard topical therapy.Keywords: central macular edema, drop less, epiretinal membrane, inflammation, moxifloxacin, triamcinolone acetonide, vitrectomy surgery, wound healing
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spelling doaj-art-645e4ac40d3d47e6aae84591c75ead1c2025-08-20T03:29:52ZengDove Medical PressClinical Ophthalmology1177-54832025-06-01Volume 19Issue 119651974104162Visual Outcomes and Safety Profile of “Dropless Vitrectomy” for Epiretinal MembranesChalam KV0Cheng AMS1Gasparian S2OphthalmologyOphthalmologyOphthalmologyKakarla V Chalam,1 Anny MS Cheng,2– 4 Suzie Gasparian1 1Department of Ophthalmology, Loma Linda University, Loma Linda, CA, USA; 2Department of Ophthalmology, Broward Health, Fort Lauderdale, FL, USA; 3Department of Ophthalmology, Specialty Retina Center, Deerfield Beach, FL, USA; 4Department of Ophthalmology, University of Florida, Gainesville, FL, USACorrespondence: Kakarla V Chalam, Department of Ophthalmology, Loma Linda University, 11370 Anderson St., Suite 1800, Loma Linda, CA, 92354, USA, Tel +1 904 403-2607, Email kakarla.chalam@gmail.comPurpose: To assess the clinical effectiveness and safety of Tri-Moxi intravitreal injection in comparison to standard postoperative topical steroid-antibiotic treatment after epiretinal membrane (ERM) removal with pars plana vitrectomy (PPV).Methods: A retrospective longitudinal cohort study of 278 eyes undergoing ERM removal by PPV was conducted from 2019 to 2023. Group 1 (N = 139) received a triamcinolone acetonide–moxifloxacin (Tri-Moxi) intravitreal injection at the conclusion of surgery, and Group 2 (N = 139) had postoperative standard topical antibiotic-steroid therapy. Clinical changes of best-corrected visual acuity (BCVA), intraocular pressure (IOP), and central foveal thickness (CFT) were evaluated.Results: By 3-month after surgery, the Tri-Moxi (Group 1) demonstrated a significantly greater reduction in CFT (178 ± 32 vs 145 ± 38 μm, P < 0.001) and a slightly superior improvement in BCVA (0.34 ± 0.03 vs 0.41 ± 0.04 logMAR, P < 0.05) compared to the standard (Group 2). Postoperative IOP remained minimal change in both groups. The occurrence of cystoid macular edema was markedly reduced in patients receiving Tri-Moxi (4% vs 10%, P = 0.02). No infection or ocular hypertension cases were recorded.Conclusion: For the postoperative management of PPV in ERM patients, intravitreal Tri-Moxi injection is an efficacious and safe alternative to standard topical therapy. Intravitreal Tri-Moxi can be used as a viable treatment option for managing inflammation and preventing infection after epiretinal membrane removal by pars plana vitrectomy. Tri-Moxi group demonstrated superior anatomical outcomes and comparable functional outcomes while simplifying postoperative care and reducing the occurrence of cystoid macular edema compared to standard topical therapy.Keywords: central macular edema, drop less, epiretinal membrane, inflammation, moxifloxacin, triamcinolone acetonide, vitrectomy surgery, wound healinghttps://www.dovepress.com/visual-outcomes-and-safety-profile-of-dropless-vitrectomy-for-epiretin-peer-reviewed-fulltext-article-OPTHCentral macular edemaDrop lessEpiretinal membraneinflammationmoxifloxacintriamcinolone acetonide
spellingShingle Chalam KV
Cheng AMS
Gasparian S
Visual Outcomes and Safety Profile of “Dropless Vitrectomy” for Epiretinal Membranes
Clinical Ophthalmology
Central macular edema
Drop less
Epiretinal membrane
inflammation
moxifloxacin
triamcinolone acetonide
title Visual Outcomes and Safety Profile of “Dropless Vitrectomy” for Epiretinal Membranes
title_full Visual Outcomes and Safety Profile of “Dropless Vitrectomy” for Epiretinal Membranes
title_fullStr Visual Outcomes and Safety Profile of “Dropless Vitrectomy” for Epiretinal Membranes
title_full_unstemmed Visual Outcomes and Safety Profile of “Dropless Vitrectomy” for Epiretinal Membranes
title_short Visual Outcomes and Safety Profile of “Dropless Vitrectomy” for Epiretinal Membranes
title_sort visual outcomes and safety profile of amp ldquo dropless vitrectomy amp rdquo for epiretinal membranes
topic Central macular edema
Drop less
Epiretinal membrane
inflammation
moxifloxacin
triamcinolone acetonide
url https://www.dovepress.com/visual-outcomes-and-safety-profile-of-dropless-vitrectomy-for-epiretin-peer-reviewed-fulltext-article-OPTH
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