Safety of prophylactic intracameral moxifloxacin 0.5% ophthalmic solution in cataract surgery patients (original) (raw)
Related papers
2011
Material and Methods: This prospective study was conducted in the department of Ophthalmology Fauji Foundation Hospital, Rawalpindi, from December 2006 to November 2007 and comprised of 200 patients. The patients were divided into two groups. Group 1 received 0.1 ml of intracameral moxifloxacin 0.5 % ophthalmic solution at the conclusion of the surgery and the patients in the group 2 were not given the intracameral antibiotic. None of the patients was given postoperative sub conjunctival antibiotic and steroid injection. All patients were examined for AC reaction and pachymetry was done preoperatively and postoperatively (first day, first week and 4 weeks postoperatively). Anterior chamber reaction and pachymetry values between the two groups were compared .Statistical analysis was done by using paired sample t test. P value of less than 0.05 was taken as significant.
Indian Journal of Clinical and Experimental Ophthalmology, 2020
To demonstrate that the combination of moxifloxacin/dexamethasone eye drops is effective and safe to prevent postoperative inflammation in cataract surgery patients. 93 patients who underwent clear corneal phacoemulsification with posterior chamber IOL were included in a 15 day open-label, single-arm study. All the patients recruited in the study were advised to use moxifloxacin 0.5%/dexamethasone 0.1% (Vigadexa) eye drops four times a day one day before and until 15 days after surgery. Intraocular pressure (IOP), Anterior chamber (AC) reaction, visual acuity and ocular pain were assessed at baseline and on postoperative days 1, 7 and 15. Out of ninety three patients 77.3% of patients had AC cells grade 3–2, while 19.3% had grade 1 AC cells on the first postoperative day. By the end of the study i.e, on 15th postoperative day 89.65% had grade 0 AC cells and 31.03% had grade 1 cells. The mean IOP preoperatively was 14.00±3.8 mm Hg. The mean IOP on first and 7th postoperative wa...
Cohort Study of Intracameral Moxifloxacin in Postoperative Endophthalmitis Prophylaxis
Ophthalmology and Eye Diseases, 2014
We conducted a cohort study to evaluate post-cataract surgery endophthalmitis rates in relation to prophylactic intracameral moxifloxacin administration. A total of 2332 patients (2674 eyes) who underwent phacoemulsification by a single surgeon from January 2007 through December 2012 were included in the study. A total of 1056 eyes did not receive intracameral prophylactic moxifloxacin and the antibiotic was injected in 1618 eyes. The incidence of presumed postoperative endophthalmitis in the 2 groups was calculated. The rate of presumed infectious endophthalmitis after cataract surgery between January 2007 and June 2009 (without intracameral moxifloxacin) was 0.094%. The rate in the second period, from July 2009 to December 2012 (with prophylactic intracameral moxifloxacin), was 0%. In our patients, a decline in the incidence of presumed infectious postoperative endophthalmitis appeared to be associated with the application of intracameral moxifloxacin.
Journal of cataract and refractive surgery, 2016
To review current and past practices of intracameral antibiotic administration for infection prophylaxis in cataract surgery; to review the benefits and liabilities of available prophylactic drugs, dosage determination, and administration protocols; and to devise an optimum dose and administration protocol for intracameral moxifloxacin. Humber River Hospital and the University of Toronto, Toronto, Ontario, Canada. Retrospective evaluation of treatment modality. This study consisted of a detailed review of the history, drugs, and methods of intracameral prophylaxis and microbiological and pharmacodynamics analysis of options. A review of potential drug sources and doses was performed and 1 drug, dose, and administration protocol was selected. The current method's adoption reasons are described followed by the authors' experience. A single infection in 3430 cases occurred with a moxifloxacin-resistant strain of Staphylococcus epidermidis when moxifloxacin 100 mcg in 0.1 mL was...
Eye & Contact Lens: Science & Clinical Practice, 2018
Purpose: Intravitreal injections of antibiotics and anti-inflammatories are used by some cataract surgeons for surgical prophylaxis. To support this prophylaxis, intravitreal triamcinolone–moxifloxacin (TM) and triamcinolone–moxifloxacin–vancomycin (TMV) were tested for preventing Staphylococcus aureus (SA) endophthalmitis in rabbits. Methods: Trademark formulations of TM (15/1 mg/mL) and TMV (15/1/10 mg/mL) were intravitreally injected into seven groups of eight rabbits each (A–G). Before intravitreal injection, the vitreous was first challenged with clinical SA endophthalmitis isolates (5,000 colony-forming unit) with varying minimum inhibitory concentrations (MICs in μg/mL) to moxifloxacin (denoted by the MIC at the end of each group listed): A) TMV-10, B) TM-10, C) Saline-10, D) TM-2, E) Saline-2, F) TM-0.032, and G) Saline-0.032. After 24 hr, the rabbit eyes were graded for clinical endophthalmitis and cultured for viable SA. Results: Rabbits treated with TMV and challenged by ...
Clinical Ophthalmology, 2020
Purpose: To compare short-term non-infectious clinical outcomes after cataract surgery with an intraoperative pars plana intravitreal antibiotic-steroid (IVAS) injection of triamcinolone, moxifloxacin, and vancomycin (TMV) versus a standard postoperative topical regimen. Patients and Methods: A retrospective comparative case series of 1058 eyes (control = 487, treatment = 571) undergoing cataract surgery were included. Endpoints included bestcorrected visual acuity (BCVA), intraocular pressure (IOP), and the unplanned use of antiinflammatory topical medication in the postoperative period. The follow-up period ranged from 1 to 6 months. Results: A final monocular BCVA of 20/25 or better was achieved in 78.8% and 87.4% of eyes in the control and treatment groups, respectively (p = 0.001). The overall incidence of an IOP spike (Δ ≥ 10 mm Hg) was not significantly different between the two groups (0.4% versus 1.9%, p = 0.027). The rates of persistent anterior chamber inflammation (PACI), rebound anterior chamber inflammation (RACI), and cystoid macular edema (CME) in the control and treatment groups were 8.0% vs 2.6% (p < 0.001), 6.4% vs 2.6% (p = 0.003), and 3.9% vs 4.7% (p = 0.511), respectively. The use of an IVAS injection of TMV conferred an increased risk of CME (odds ratio [OR] = 3.21, 95% confidence interval [CI] = 1.42 to 7.23) but no significant effect on the risk of PACI (OR = 0.34, 95% CI = 0.10 to 1.14) or RACI (OR = 0.52, 95% CI = 0.18 to 1.54) when compared to a topical regimen. Conclusion: An intraoperative IVAS injection after uncomplicated cataract surgery may be as safe and effective as a standard topical regimen in terms of postoperative IOP and anterior chamber inflammatory events, respectively. However, the efficacy of a TMV formulation for CME prophylaxis appears to be unsatisfactory. Future studies with prospective and randomized designs are needed to further evaluate this technique.
Safety of Prophylactic Intracameral Moxifloxacin During Phacoemulsification
2013
Aim of the work: To evaluate the safety of Intracameral moxifloxacin during standard coaxial phacoemulsification .Subjects and Methods: a prospective randomized controlled clinical trial. Sixty patients with 60 eyes were divided into two Groups: Group, 1: Vigamox group (30 eyes), Group 2: Control group (30 eyes) Injection of 0.1cc Moxifloxacin using insulin 30G syringe in group 1were done at the end of Standard coaxial phacoemulsification with Foldable IOL. Results The mean age was 64.2 ± 7.8 years. The preoperative VA range from HM to 6/12 which changed postoperatively as mostly improved more than 6/18 with a total lines gained up to 12 lines. The intraoperative complications, were few in which 4 eyes showed posterior capsular dehiscence, 1 eye with Positive Vitreous Pressure (3.3%) & one case of Vitreous Prolapse (3.3%). Post-operative complications was corneal edema which was slightly more in vigamox group than that occurring in the control group, corneal edema occurred in 8 cases in the vigamox group and 6 cases in the control group, 5 cases suffered from Suture-Induced Astigmatism. Unfortunately there was one case suffered from endophthalmitis, one with Pupillary Block, one with Retained Lens Material, one case of media opacity, also one case with Shallow Anterior Chamber. The average endothelial cell density in the control group was 2366.75 and changed to 2083.75.While the average endothelial cell density in the vigamox group was 2533.21 then one month postoperatively changed to 2006.29 meaning that there was a decrease of 283 in the control group compared to the 526.93 decrease in the vigamox group. Conclusion: Intracameral 0.1 ml of 0.5% moxifloxacin (Vigamox, Alcon) was found to be safe for the visual rehabilitation and corneal endothelium,. Use of Intracameral moxifloxacin can be a beneficial adjunct to topical dosing for surgical prophylaxis.
Clinical Ophthalmology, 2012
The purpose of this study was to evaluate the safety and tolerability of besifloxacin ophthalmic suspension 0.6% compared with moxifloxacin ophthalmic solution 0.5%, when used for infection prophylaxis following uncomplicated phacoemulsification clear cornea surgery using sutureless corneal incision. Methods: This prospective, two-site, parallel-group, investigator-masked clinical study included patients aged 18yearsscheduledtoundergophacoemulsificationwithintraocularlensimplantation.Patientsreceivedonedropofeitherbesifloxacinophthalmicsuspensionormoxifloxacinophthalmicsolutionfourtimesdaily,beginning3dayspriortosurgery,whichwascontinuedfor7dayspostoperatively.Theprimaryendpointwastherateofadverseevents.Secondaryendpointsincludedendothelialcellcount,centralcornealthickness,andoverallandcentralcornealstainingmeasuredondays7(±1day)and28(±2days)followingsurgery,andintraocularpressureandbest−correctedvisualacuitymeasuredondays1,7(±1day),and28(±2days)followingsurgery.Results:Ofthe60patientsenrolled,58(29pertreatmentgroup)completedthestudy.Noadverseeventswerereportedineithertreatmentgroup.Changesinthecentralcornealthickness,endothelialcellcount,andcornealstainingweresmallandsimilarbetweentreatmentsatfollow−upvisits(P18 years scheduled to undergo phacoemulsification with intraocular lens implantation. Patients received one drop of either besifloxacin ophthalmic suspension or moxifloxacin ophthalmic solution four times daily, beginning 3 days prior to surgery, which was continued for 7 days postoperatively. The primary endpoint was the rate of adverse events. Secondary endpoints included endothelial cell count, central corneal thickness, and overall and central corneal staining measured on days 7 (±1 day) and 28 (±2 days) following surgery, and intraocular pressure and best-corrected visual acuity measured on days 1, 7 (±1 day), and 28 (±2 days) following surgery. Results: Of the 60 patients enrolled, 58 (29 per treatment group) completed the study. No adverse events were reported in either treatment group. Changes in the central corneal thickness, endothelial cell count, and corneal staining were small and similar between treatments at follow-up visits (P 18yearsscheduledtoundergophacoemulsificationwithintraocularlensimplantation.Patientsreceivedonedropofeitherbesifloxacinophthalmicsuspensionormoxifloxacinophthalmicsolutionfourtimesdaily,beginning3dayspriortosurgery,whichwascontinuedfor7dayspostoperatively.Theprimaryendpointwastherateofadverseevents.Secondaryendpointsincludedendothelialcellcount,centralcornealthickness,andoverallandcentralcornealstainingmeasuredondays7(±1day)and28(±2days)followingsurgery,andintraocularpressureandbest−correctedvisualacuitymeasuredondays1,7(±1day),and28(±2days)followingsurgery.Results:Ofthe60patientsenrolled,58(29pertreatmentgroup)completedthestudy.Noadverseeventswerereportedineithertreatmentgroup.Changesinthecentralcornealthickness,endothelialcellcount,andcornealstainingweresmallandsimilarbetweentreatmentsatfollow−upvisits(P 0.1549). Intraocular pressure was similar between treatment groups at each visit, as was the distribution of best-corrected visual acuity. The final best-corrected visual acuity was 20/30 or better in 85% of the patients. Conclusion: In this study, besifloxacin ophthalmic suspension 0.6% was well tolerated when used prophylactically to prevent postoperative endophthalmitis following sutureless cataract surgery.