Purpose
To evaluate endothelial cell changes with 3 different quinolones compared with Balanced Saline Solution (BSS).
Methods
The in vitro effect of antibiotic eye drops on the viability of human umbilical vein endothelial cells (HUVEC) was evaluated. 60 eyes New Zealand White Rabbits, between 1.000-1.200g were divided into four groups: besifloxacin 0.06%, gatifloxacin 0.03%, moxifloxacin 0.05% and BSS. Antibiotic concentrations above were achieved with a 1:10 dilution of commercially available antibiotics drops. Groups were subdivided in 1h, 3h and 24h. Each subggroup was submitted to intracameral injections of 0.15mL of the corresponding solution. Procedure was done with a 30 G needle 0.30mL syringe. Pachymetery measurements were taken before injection and before euthanasia with an ultrasound pachymeter (Accutome Inc®, Malvern, PA) and manual trephination was performed. Corneal buttons obtained were dyed with trepan blue and alizarin red S, and photomicrographs taken. Cell density was obtained with imageJ software (www.fiji.sc) and results were compared.
Results
Results: Mean pachymetry measurements taken pre and postoperative in the 1h,3h and 24h subgroups were, respectively: Besifloxacin, 321 and 324(p = 0.60), 323 and 331(p = 0.24), 313 and 323(p = 0.20); Gatifloxacin, 315 and 318(p = 0.57), 326 and 337(p = 0.13), 318 and 324(p = 0.43); Moxifloxacin, 319 and 333(p = 0.16), 323 and 349 (P < 0.001), 319 and 346(p < 0.001); BSS, 321 and 323(p = 0.71), 321 and 323(p = 0.55), 325 and 326(p = 0.55). Mean cell density in 1h,3h and 24h subgroups was respectively: Besifloxacin, 3390±165cells/mm2, 2693±284cells/mm2, 1640±92cells/mm2; Gatifloxacin, 3780±293cells/mm2, 3256±158cells/mm2, 2645±295cells/mm2; Moxifloxacin 4166±206cells/mm2, 4113±235cells/mm2, 3569±213cells/mm2; BSS, 5075±286cells/mm2, 4911±170cells/mm2, 4694±92cells/mm2. Comparison between all antibiotics subgroups with BSS subgroups with t-test showed statistical significant difference (p < 0.0001).
Conclusions
Conclusions: Our data showed a statistically significant difference regarding endothelial cell density reduction comparing antibiotics to BSS and that endothelial cell loss is worse in the following decrescent order: besifloxacin, gatifloxacin and moxifloxacin. Our results suggest that intracameral antibiotic injection is a risk factor for endothelial injury and further studies should be carried out to better elucidate the extent of this risk.