Abstract
Purpose::
To establish the safety of self-preserved intracameral moxifloxacin (Vigamox) at the conclusion of routine cataract surgery for the purpose of endophthalmitis prophylaxis including its affect on corneal status, visual acuity (VA), & anterior chamber reaction.
Methods::
Consecutive cataract procedures with self-preserved intracameral diluted moxifloxacin were studied. Corneal clarity, visual acuity, and anterior chamber cells outcome measures were evaluated. Outcomes were compared with consecutive historical control patients (N=100) who did not receive intracameral moxifloxacin.
Results::
A total of 200 consecutive cataract procedures with intracameral moxifloxacin were included in this report. There were 53 males and 88 females with age at surgery ranging from 27 to 94 years (mean, 71; SD, 12). The control group had similar demographic characteristics. At Day 1 post-op, four (2.0%) treated eyes had aqueous cell counts of 3+ or more, compared to 11 (11.0%) eyes in the control group (p=0.0007, Pearson Chi-square test). At 1 week post-op, 95% of the treated group had none or trace cells compared to 96% of controls (p=0.6987) Similarly, 5.0% and 4.0% in treated and the control group, respectively had 1+ or 2+ cells. No post-op epithelial defect or stromal edema was observed in the treated group. Post-op epithelial defect was reported in one control patient who had pre-existing MDFD. Visual acuity was not comparable between groups at baseline and prevented a valid comparison. However, both groups were approximately 20/25 1 week post-op.
Conclusions::
To date, there is no evidence of any deleterious effect of intracameral moxifloxacin injections after cataract surgery. As there is now good evidence that intracameral antibiotic reduces the incidence of endophthalmitis after cataract surgery, employing this readily available broad-spectrum potent antibiotic in this highly bioavailable form may increase the safety of this frequent procedure.
Keywords: cataract • antibiotics/antifungals/antiparasitics • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials