Skip to main content
Top
Published in: International Ophthalmology 4/2016

01-08-2016 | Original Paper

Safety of undiluted intracameral moxifloxacin without postoperative topical antibiotics in cataract surgery

Authors: Andrew Xingyu Zhou, Wyatt Boyer Messenger, Steven Sargent, Balamurali Krishna Ambati

Published in: International Ophthalmology | Issue 4/2016

Login to get access

Abstract

The objective of this study is to evaluate the safety of undiluted 0.5 % intracameral moxifloxacin for postoperative endophthalmitis prophylaxis in cataract surgery patients without the use of additional postoperative topical antibiotics. All phacoemulsification cataract surgeries performed by a single surgeon (B.A.) at the John A. Moran Eye Center from June 2012 to May 2015 were reviewed retrospectively. From June 2012 to April 2014, patients were given topical 0.5 % moxifloxacin postoperatively. From May 2014 to May 2015, all patients were given moxifloxacin intracamerally with no antibiotics postoperatively. The follow-up period was 1 month after surgery. Preoperative visual acuity and postoperative visual acuity, corneal edema, and anterior chamber reaction were recorded and compared between the two groups. 384 cataract surgeries were performed during the study period. None of the 384 eyes in the study developed endophthalmitis. Of those 384 eyes, 222 were included in the study for analysis based on the inclusion and exclusion criteria. 131 were part of the topical antibiotic group and 91 were part of the intracameral group. The differences in uncorrected visual acuity at 1 day postoperatively (p = 0.595) and best corrected visual acuity at 1 month postoperatively (p = 0.099) were not statistically significant. Differences in corneal edema (p = 0.370) and anterior chamber reaction (p = 0.069) at 1 day postoperatively and corneal edema (p = 0.512) and anterior chamber reaction (p = 0.512) at 1 month postoperatively were also not statistically significant. Undiluted 0.5 % moxifloxacin can be safely injected intracamerally following cataract surgery without additional postoperative antibiotic prophylaxis to prevent endophthalmitis without adverse effects on patient outcomes.
Literature
1.
go back to reference Cullen K, Hall M, Golosinskiy A (2009) Ambulatory surgery in the United States, 2006. National health statistics reports Cullen K, Hall M, Golosinskiy A (2009) Ambulatory surgery in the United States, 2006. National health statistics reports
3.
go back to reference Kam JK, Buck D, Dawkins R, Sandhu SS, Allen PJ (2014) Survey of prophylactic intracameral antibiotic use in cataract surgery in an Australian context. Clin Exp Ophthalmol 42(4):398–400. doi:10.1111/ceo.12199 CrossRef Kam JK, Buck D, Dawkins R, Sandhu SS, Allen PJ (2014) Survey of prophylactic intracameral antibiotic use in cataract surgery in an Australian context. Clin Exp Ophthalmol 42(4):398–400. doi:10.​1111/​ceo.​12199 CrossRef
5.
go back to reference Chang DF, Braga-Mele R, Henderson BA, Mamalis N, Vasavada A, Committee ACC (2015) Antibiotic prophylaxis of postoperative endophthalmitis after cataract surgery: results of the 2014 ASCRS member survey. J Cataract Refract Surg 41(6):1300–1305. doi:10.1016/j.jcrs.2015.01.014 CrossRefPubMed Chang DF, Braga-Mele R, Henderson BA, Mamalis N, Vasavada A, Committee ACC (2015) Antibiotic prophylaxis of postoperative endophthalmitis after cataract surgery: results of the 2014 ASCRS member survey. J Cataract Refract Surg 41(6):1300–1305. doi:10.​1016/​j.​jcrs.​2015.​01.​014 CrossRefPubMed
6.
go back to reference Endophthalmitis Study Group ESoC, Refractive S (2007) Prophylaxis of postoperative endophthalmitis following cataract surgery: results of the ESCRS multicenter study and identification of risk factors. J Cataract Refract Surg 33(6):978–988. doi:10.1016/j.jcrs.2007.02.032 CrossRef Endophthalmitis Study Group ESoC, Refractive S (2007) Prophylaxis of postoperative endophthalmitis following cataract surgery: results of the ESCRS multicenter study and identification of risk factors. J Cataract Refract Surg 33(6):978–988. doi:10.​1016/​j.​jcrs.​2007.​02.​032 CrossRef
7.
8.
go back to reference Seppala H, Al-Juhaish M, Jarvinen H, Laitinen R, Huovinen P (2004) Effect of prophylactic antibiotics on antimicrobial resistance of viridans streptococci in the normal flora of cataract surgery patients. J Cataract Refract Surg 30(2):307–315. doi:10.1016/S0886-3350(03)00617-5 CrossRefPubMed Seppala H, Al-Juhaish M, Jarvinen H, Laitinen R, Huovinen P (2004) Effect of prophylactic antibiotics on antimicrobial resistance of viridans streptococci in the normal flora of cataract surgery patients. J Cataract Refract Surg 30(2):307–315. doi:10.​1016/​S0886-3350(03)00617-5 CrossRefPubMed
15.
go back to reference Holladay JT (1997) Proper method for calculating average visual acuity. J Refract Surg 13(4):388–391PubMed Holladay JT (1997) Proper method for calculating average visual acuity. J Refract Surg 13(4):388–391PubMed
17.
go back to reference Matsuura K, Suto C, Akura J, Inoue Y (2013) Comparison between intracameral moxifloxacin administration methods by assessing intraocular concentrations and drug kinetics. Graefes Arch Clin Exp Ophthalmol 251(8):1955–1959. doi:10.1007/s00417-013-2294-7 CrossRefPubMed Matsuura K, Suto C, Akura J, Inoue Y (2013) Comparison between intracameral moxifloxacin administration methods by assessing intraocular concentrations and drug kinetics. Graefes Arch Clin Exp Ophthalmol 251(8):1955–1959. doi:10.​1007/​s00417-013-2294-7 CrossRefPubMed
20.
go back to reference Haas W, Pillar CM, Torres M, Morris TW, Sahm DF (2011) Monitoring antibiotic resistance in ocular microorganisms: results from the Antibiotic Resistance Monitoring in Ocular micRorganisms (ARMOR) 2009 surveillance study. Am J Ophthalmol 152(4):567–574 e563. doi:10.1016/j.ajo.2011.03.010 Haas W, Pillar CM, Torres M, Morris TW, Sahm DF (2011) Monitoring antibiotic resistance in ocular microorganisms: results from the Antibiotic Resistance Monitoring in Ocular micRorganisms (ARMOR) 2009 surveillance study. Am J Ophthalmol 152(4):567–574 e563. doi:10.​1016/​j.​ajo.​2011.​03.​010
24.
go back to reference Sharifi E, Porco TC, Naseri A (2009) Cost-effectiveness analysis of intracameral cefuroxime use for prophylaxis of endophthalmitis after cataract surgery. Ophthalmology 116(10):1887–1896 e1881. doi:10.1016/j.ophtha.2009.03.014 Sharifi E, Porco TC, Naseri A (2009) Cost-effectiveness analysis of intracameral cefuroxime use for prophylaxis of endophthalmitis after cataract surgery. Ophthalmology 116(10):1887–1896 e1881. doi:10.​1016/​j.​ophtha.​2009.​03.​014
26.
go back to reference Lexicomp Online®, Lexi-Drugs®. Hudson, OH, USA: Lexi-Comp, Inc. Accessed 30 July 2015 Lexicomp Online®, Lexi-Drugs®. Hudson, OH, USA: Lexi-Comp, Inc. Accessed 30 July 2015
Metadata
Title
Safety of undiluted intracameral moxifloxacin without postoperative topical antibiotics in cataract surgery
Authors
Andrew Xingyu Zhou
Wyatt Boyer Messenger
Steven Sargent
Balamurali Krishna Ambati
Publication date
01-08-2016
Publisher
Springer Netherlands
Published in
International Ophthalmology / Issue 4/2016
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-015-0151-x

Other articles of this Issue 4/2016

International Ophthalmology 4/2016 Go to the issue