Trimoxi During Cataract Surgery

Trimoxi During Cataract Surgery

Trimoxi is a medication that is injected into the eye at the time of cataract surgery. It is a compounded injection that consists of Triamcinolone and Moxifloxacin. The surgeon will inject the Trimoxi through the pars plana into the vitreous. A trial ad already been done with Trimoxi and we were happy with the results and the added benefits to the patients.

We are rolling out this medication for all cataract surgery patients over the next few week for surgeons Scott Perkins, MD, Neil Atodaria, MD David McGarey, MD and John Knippers, MD. Shivi Agrawal, MD plans to begin using it after she returns from her three month maternity leave.

Our surgeons and staff will be informing patients post-operatively that they will see a “moving cloud” in their vision, which decreases during the first few days to a week post-op. This will likely be the most common complaint you hear at the first post-op visit.

Over 90% of these patients will not need to use any post-op drops. But for those patients that do get break through iritis, you can prescribe generic topical steroids and / or NSAIDS, or of course what you determine is best for the patient.

There are some patients who may need supplemental drops due to an increased risk of inflammation.
These patients have:
1. History of CME (including fellow eye)
2. History of ERM (in the surgical eye)
3. Diabetic Retinopathy (more than mild)
4. Chronic Iritis (in the surgical eye)
5. African American

These patients will receive a prescription for the supplemental drops in clinic at their pre-op appointment. The prescription will be for steroid and non-steroid drops. If the patient has an allergy to NSAIDS, they will only get a prescription for steroid drops. Patients will use these drops on night of surgery and will continue for 2 weeks post-operatively, at the frequency of three times a day.

Patients allergic to any component of Trimoxi can still use Trimoxi as the effect of the medication is confined to the eye. Increased IOP can occur but it is much less likely than you would expect and, with Trimoxi, occurs at a lower rate than with previous post-op drop regimen.

Patients with end-stage glaucoma will not receive Trimoxi but will use the current drop regimen or the equivalent.

There are several benefits to the patients getting the Trimoxi injections versus using drops:
1. Less confusing for the patients on what drops to use and when
2. The expense to the patient for the drops
3. Lessens the risk of infection due to non-compliance with drops and or hygiene
4. Less corneal toxicity

We are confident that the benefit to your patients is enormous. As we begin this new and exciting transition to using Trimoxi, please assist us by determining any issues that need resolution and communicate them to us whenever needed.

Below you will find the pre and post operative instructions for patients receiving Trimoxi.

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August 16, 2017

Thursday, October 26th from 6:00 pm to 8:30 pm Co-Managing Cataract, MIGS and Laser Refractive Surgery  by: Aaron Amacher III, MD Managing the Reluctant Glaucoma Patient  by: Andrew Rabinowitz, MD Location: Desert Willow Conference Center. 4340 E. Cotton Center Blvd., Phoenix, AZ 85040 Seating is Limited Register Today

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Trimoxi During Cataract Surgery

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Trimoxi is a medication that is injected into the eye at the time of cataract surgery. It is a compounded injection that consists of Triamcinolone and Moxifloxacin. The surgeon will inject the Trimoxi through the pars plana into the vitreous. A trial ad already been done with Trimoxi and we were happy with the results and the added benefits to

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