May 2007
Volume 48, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2007
Pharmacokinetics of Vancomycin Following Intracameral Bolus Injection in Patients Undergoing Phacoemulsification Cataract Surgery
Author Affiliations & Notes
  • C. C. Murphy
    Royal Liverpool Univ Hospital, Liverpool, United Kingdom
    Ophthalmology,
  • S. Nichollson
    Royal Liverpool Univ Hospital, Liverpool, United Kingdom
    Ophthalmology,
  • S. A. Quah
    Royal Liverpool Univ Hospital, Liverpool, United Kingdom
    Ophthalmology,
  • M. Batterbury
    Royal Liverpool Univ Hospital, Liverpool, United Kingdom
    Ophthalmology,
  • T. Neal
    Royal Liverpool Univ Hospital, Liverpool, United Kingdom
    Microbiology,
  • S. B. Kaye
    Royal Liverpool Univ Hospital, Liverpool, United Kingdom
    Ophthalmology,
  • Footnotes
    Commercial Relationships C.C. Murphy, None; S. Nichollson, None; S.A. Quah, None; M. Batterbury, None; T. Neal, None; S.B. Kaye, None.
  • Footnotes
    Support None.
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 1059. doi:
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      C. C. Murphy, S. Nichollson, S. A. Quah, M. Batterbury, T. Neal, S. B. Kaye; Pharmacokinetics of Vancomycin Following Intracameral Bolus Injection in Patients Undergoing Phacoemulsification Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1059.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose:: To determine the elimination kinetics of intracameral vancomycin administered as a bolus injection at the end of phacoemulsification cataract surgery.

Methods:: Vancomycin 1mg/0.1ml saline solution was administered to 19 patients by intracameral bolus injection at the end of routine cataract surgery. The aqueous concentration of vancomycin was determined in 9 patients 1 minute after administration and in 10 patients approximately 20 hours post-operatively. Aqueous samples were obtained by inserting a Rycroft cannula into the anterior chamber via the side port incision. Fluorescence polarisation immunoassay was used to calculate the aqueous vancomycin concentration.

Results:: The median (interquartile range) vancomycin concentration was 5458 (4756 - 6389) mg/L and 40.6 (25.9 - 47.1) mg/L at 1 minute and 18 to 24 hours (median 19 hours) post-operatively, respectively. The vancomycin concentration exceeded the minimum inhibitory concentration of endophthalmitis-causing gram positive bacteria on average by a factor of between 8-10 twenty-four hours post-operatively. No adverse events or reactions were noted.

Conclusions:: The concentration of vancomycin in the anterior chamber vastly exceeds therapeutic levels for at least 24 hours following bolus intracameral injection at the end of cataract surgery.

Keywords: cataract • endophthalmitis 
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