Abstract
Purpose: :
To quantify antibiotic concentrations acheivable in the anterior chamber of the eye using various methods of intrastromal corneal antibiotic administration.
Methods: :
An in vitro model for the detection and quantification of topical, intracameral and intrastromal antibiotic administration (penetrating incision and non-penetrating pocket) using human corneal-scleral rims and high performance liquid chromotography was developed and validated. Time-concentration curves were obtained for various methods of corneal intrastromal antibiotic administration as well as standard methods for the administration of antibiotic.
Results: :
Intrastromal antibiotic hydration of a cataract surgery incision resulted in a peak anterior chamber antibiotic concentration immediately after administration and remained above the MIC90 for most reported clinically significant endo-ophthalmitis isolates (302 ng/mL) until approximately 10 hrs after administration. Intrastromal hydration of a pocket (non-penetrating) corneal incision resulted in a peak anterior chamber concentration at approximately 3 hrs after administration (21600 ng/ml) and remained above the MIC90 of most reported clinically significant endophthalmitis isolates until 11 hrs (213 ng/ml). Concentration-time curves were compared to intracameral and topical antibiotic administration.
Conclusions: :
Intrastromal corneal administration of antibiotics may be a useful adjunct method for antibiotic prophylaxis in the setting of cataract and refractive surgery.
Keywords: cataract • antibiotics/antifungals/antiparasitics • bacterial disease