Maxitrol Ophthalmic Ointment Versus Prednisolone Acetate and Gentamicin Eye Drops after Pars Plana Vitrectomy: A Retrospective Chart Review

Background: Maxitrol ophthalmic ointment is a combination anti-inflammatory and antibiotic agent commonly used to manage post-operative inflammation and infection. In July 2019, Altaire Pharmaceuticals, Inc. announced the recall of 99 eye-care products as a precautionary measure due to quality assurance concerns. Recalled products included the generic Maxitrol ophthalmic ointment which is covered by most insurance plans, including Medicare and costs around $20 in the United States. The recall led to its shortage, and consequently, patients who were prescribed the Maxitrol ophthalmic ointment for their post-operative regimen were obliged to purchase the branded version at its full out-of-pocket cost ($213) as it is not covered by many insurance plans, including Medicare. The Prednisolone Acetate and Gentamicin eye drops have a combined retail price of $56, but are covered by Medicare and most insurance plans. They have been shown to be safe and effective against post-surgical inflammation and infection after cataract surgeries. In this study, we aim to compare the safety and efficacy of Maxitrol ophthalmic ointment and combination Prednisolone Acetate/Gentamicin eye drops on post-operative ocular inflammation and prevention of infection after pars plana vitrectomy (PPV). Main Body This was a retrospective study including all patients that underwent PPV for macular hole repair, epiretinal membrane, vitreous debris removal, vitreous hemorrhage, and severe floaters from February 2019 to 2021. Patients with retinal detachment surgeries and diabetes were excluded due to wider variation in inflammation. The medical records of all surgical patients were thoroughly reviewed for the six-month post-operative period and clinical data points regarding infection and inflammation were recorded. Fischer’s exact test was utilized to analyze the data. Of 337 PPV surgeries, 178 eyes fulfilled the inclusion criteria. During the six-month post-operative period, there was no statistical difference in post-operative rates of infection or inflammation ( p = 1.0). Conclusion: Both treatments were equally as safe and effective after PPV. This data is critical in allowing clinicians to optimize post-operative regimens, allowing flexibility regarding back orders of medication, sensitivity to ease of application, and awareness of cost-effectiveness.