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P. J. Ness, N. Mamalis, L. Werner, S. Maddula, D. K. Davis, E. Donnenfeld, R. J. Olson; An Anterior Chamber Toxicity Study Evaluating Besivance, Azasite and Ciprofloxacin. Invest. Ophthalmol. Vis. Sci. 2010;51(13):6420.
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We determine whether Besivance® and AzaSite® (both with DuraSite® bioadhesive), and ciprofloxacin are toxic inside the anterior chamber.
20 New Zealand white rabbits (40 eyes) were randomized to one of four study groups: Besivance, AzaSite, ciprofloxacin and balanced salt solution (BSS). Each eye was injected with 0.1 mL of the study medication. Clinical slit lamp examinations were conducted at 24 and 48 hours post-injection. All rabbits were then sacrificed and all eyes enucleated. We randomized eyes to either corneal vital staining or histopathologic examination. The main outcome measures were clinical and pathologic signs of toxicity.
The two DuraSite-based study groups (Besivance and AzaSite) showed both clinically and pathologically significant differences when compared to ciprofloxacin and BSS groups. Besivance and AzaSite eyes exhibited significantly similar and severe clinical damage, including severe corneal edema. Ciprofloxacin and BSS eyes appeared very similar and had only mild conjunctival injection and limbal vascularity. Vital staining and histopathologic evaluation revealed glaucomatous and toxic damage in eyes given DuraSite-based medications, while non-DuraSite groups showed minimal changes.
DuraSite blocks the trabecular meshwork and may be additionally toxic. Until the safety of these medications is established, we recommend they not be used after a clear corneal incision unless a suture is placed.
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