Novel Postoperative Dropless Protocol for Micro-Incision Vitrectomy Surgery

BACKGROUND AND OBJECTIVE: To evaluate the outcomes of a novel postoperative dropless protocol for 25-gauge and 27-gauge micro-incision vitrectomy surgery (MIVS). PATIENTS AND METHODS: 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. RESULTS: 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) post-operatively (P = 0.004). Mean intraocular pressure increased from 14.5 (+/- 4.3) to 15.5 (+/- 4.8) post-operatively (P < 0.001). Mean follow-up was 96 days. CONCLUSION: 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.