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Richard A Eiferman, Dale P DeVore; SUSTAINED INTRACAMERAL DRUG DELIVERY USING CROSS-LINKED HYALURONIC ACID. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4455.
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While intracameral antibiotic injections have been advocated as prophylaxis against endophthalmitis, they are quickly diluted by fresh aqueous humor as well as lost via outflow through the trabecular meshwork. We have devised a unique method to cross-link hyaluronic acid that traps antibiotic in a “molecular cage”. This provides a biodegradable slow release delivery system that delivers moxifloxacin at bacteriocidal levels for over 72 hours
Hyaluronic acid is cross-linked by a novel process and 1 mg of fluoroscein tagged moxifloxacin is added. This immediately forms a small viscoelastic droplet which contains the antibiotic. An artifical anterior chamber with a voluime of 500ul was constructed with two ports . Normal saline was added @ 2.5ul/min using an infusion pump and the fluid was collected from the other port. Aliquots are withdrawn at 1, 6, 12, 24, 48 and 72 hours. The studies were done in triplicate. Moxifloxacin levels were measured in a fluorometer at each time point.
The cross-linked hyaluronic acid containing moxifloxacin slowly hydrolyzed releasing the antibiotic. At one hour, the moxifloxacin measured 525 ug. At 6 and 12 hours, the moxifloxacin averaged >300 ug. At 24 hours, the moxifloxacin averaged >150 ug; at 48 hours, themoxifloxacin levels averaged 100 ug and at 72 hours, the vancomycin levels averaged 50ug. At all time points, the antibiotic was above bacteriocidal levels for most pathogens
The use of cross-linked hyaluronic acid can provide a sustained release of medication. When placed in the anterior chamber, this method may eliminate the need for patients to self administer post operative antibiotic eye drops
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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