Intracameral moxifloxacin after cataract surgery: a prospective study

ABSTRACT Objective: To study the safety parameters associated with intracameral moxifloxacin application five weeks after cataract surgery. Methods: The study was a prospective case series set in a private hospital in Recife, Pernambuco, Brazil. A consecutive sample of 1,016 cataract surgeries was evaluated. The inclusion criteria were patients with indications for cataract surgery, a minimum of 55 years of age, and no history of allergy to quinolones. Patients were prepared for surgery using a 5% povidone solution diluted as a topical antiseptic agent. The operative technique was phacoemulsification with intraocular lens implantation. A 0.3-mL syringe was partially filled with moxifloxacin and 150 µg/0.03 mL of moxifloxacin was administered through the surgical incision at the end of the surgery. Postoperatively, patients were prescribed: (1) 0.5% moxifloxacin eyedrops 5 times daily for 1 week, and (2) 1% prednisolone acetate eyedrops 5 times daily for 1 week, followed by 4 times daily for 1 week and, subsequently, 2 times daily for 3 weeks. The outcomes were incidence of acute endophthalmitis, mean changes from baseline to 5 postoperative weeks in corneal endothelial cell density, corrected distance visual acuity and intraocular pressure. Results: The mean age was 67 ± 5 years, and 56.2% of the patients were female. There were no cases of endophthalmitis. The mean preoperative corrected distance visual acuity was 58 letters ± 10 (SD), and the mean postoperative corrected distance visual acuity was 80 letters ± 4 (SD). The mean change in corneal endothelial cell density was 249 cells/mm (-10.3%). There was almost no difference in intraocular pressure. No study-related adverse events were observed. Conclusion: The results suggest moxifloxacin is a safe option for intracameral use after cataract surgery.

【摘要】目的：探讨白内障手术术后5周应用前房内莫西沙星（intracameral moxifloxacin）相关的安全性参数。方法：本研究为前瞻性病例系列研究，研究地点设于巴西伯南布哥州累西腓的一所私立医院。共纳入1016例连续接受白内障手术的病例进行评估。纳入标准为：具备白内障手术指征、年龄≥55岁、无喹诺酮类（quinolones）药物过敏史。患者术前以5%聚维酮溶液作为局部消毒剂进行术前准备。手术方式采用超声乳化术（phacoemulsification）联合人工晶状体植入术（intraocular lens implantation）。手术结束时，使用预先装填了部分莫西沙星的0.3mL注射器，通过手术切口给予150μg/0.03mL的莫西沙星。术后给药方案如下：（1）0.5%莫西沙星滴眼液，每日5次，持续1周；（2）1%醋酸泼尼松龙滴眼液，每日5次，持续1周，随后调整为每日4次，持续1周，再改为每日2次，持续3周。本研究的结局指标包括：急性眼内炎（acute endophthalmitis）发生率、术后5周较基线时角膜内皮细胞密度（corneal endothelial cell density）、矫正远视力（corrected distance visual acuity）及眼压（intraocular pressure）的平均变化值。结果：受试者平均年龄为67±5岁，女性占比56.2%。未发生急性眼内炎病例。术前平均矫正远视力为58±10个字母（标准差，SD），术后平均矫正远视力为80±4个字母（标准差，SD）。角膜内皮细胞密度平均变化量为249个细胞/mm，降幅达10.3%。眼压几乎无明显变化。未观察到与本研究相关的不良事件。结论：本研究结果提示，莫西沙星用于白内障术后前房内给药是一种安全的选择。