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Chirantan Mukhopadhyay, Andrew Greenberg, Edward F. Smith, Amilia Schrier; Novel Technique for the Delivery of Intracameral Antibiotics. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4726.
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To determine if a hydrophobic acrylic intraocular lens coated in commercially available moxifloxacin 0.5% would be able to deliver clinically significant antibiotic levels after being injected through a Monarch II D (Alcon) cartridge. The IOL delivery was performed with a cartridge filled with sodium hyaluronate (Healon®, Abbott Medical Optics) as is done in routine cataract procedures.
30 microliters of moxifloxacin 0.5% (Vigamox®, Alcon) was injected directly into the plastic case containing one of two types of acrylic IOLs (AcrySof ® SA60AT and SN60WF, Alcon) via preexisting ports in the lens packaging. The IOL was allowed to soak in the antibiotic within the commercial packaging for one minute. Nine IOLs were injected onto a Muller Hinton agar plate seeded with Staphylococcus epidermidis without rinsing the sodium hyaluronate and eight IOLs were injected onto plates after rinsing with BSS for one minute. This process was then repeated using agar plates seeded with Staphylococcus aureus. For this group, the N values were 9 for the rinse group and 9 for the non-rinse group. A control group consisted of IOLs not soaked in antibiotic which were plated using the above methods. All the plates were incubated for 24 hours. Plates were photographed and the resulting inhibitory zone surrounding the IOL was measured.
In the Staphylococcus epidermidis group, the average inhibitory zone was 22.44 mm with a standard deviation (SD) of 8.19 in the BSS rinse group, and 27.75 mm with an SD of 8.71 in the non-rinsed group. In the Staphylococcus aureus group, the average inhibitory zone was 24.44 mm with a 6.02 S.D and 22.78 mm with a 1.99 SD in the rinsed and non-rinsed group respectively.
This study demonstrates that IOLs soaked in antibiotic solution in their native packaging and injected through sodium hyaluronate, in a process similar to that used in routine cataract extraction surgery, allows the lenses to act as drug depots with antimicrobial properties in vitro.
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