Prevention of Bacterial Endophthalmitis With Viscoelastic Material Contained Anti-Bacterial Drug

Abstract

Abstract: : Purpose: We showed the risk of the postoperative bacterial endophthalmitis with the residual viscoelastic material at the last ARVO meeting. Then, the protective efficacy to the postoperative bacterial endophthalmitis of viscoelastic material contained anti-bacterial drug was examined. Methods: The experimental bacterial endophthalmitis model was made by using Japanese white rabbits (32 eyes). The strain was Staphylococcus aureus (Smith).The anti-bacterial drug was Levofloxacin (LVFX). Viscoelastic materials were Healon and Viscoat. Bacterial inocula [10⁴cfu/eye] were injected to the anterior chamber of rabbit under general anesthesia. Inoculation were the following two groups; Group-A) viscoelastic material contained anti-bacterial drug (viscoelastic material + bacteria + anti-bacterial drug), and Group-B) the eye drop treatment group (viscoelastic material +bacteria). The LVFX concentrations were 4µg/ml. The injection volumes were approximately 0.1ml/eye. In the eye drop treatment group, 0.5% LVFX eye drop were administrated topically four times a day from the day before the injection until the enucleation. Every 24 and 48 hours later, clinical observation and bacterial culture of the aqueous humor were done under general anesthesia. The eyeball was removed 48 hours later under euthanasia. The histopathological examinations were performed. Results: In the Group-A, the bacterial endophthalmitis were observed three eyes of 16 eyes (Healon 1/8, Viscoat 2/8, total 3/16). In the Group-B, the bacterial endophthalmitis were observed 15 eyes of 16 eyes (Healon 7/8, Viscoat 8/8, total 15/16). A significant difference was seen between both groups (p<0.01). In both groups, any bacteria were not detected in the aqueous humor every 24 and 48 hours later. Histopathological findings of endophthalmitis eye showed bacterial colonization to the surface of iris. Conclusions: The viscoelastic material contained anti-bacterial drug has significantly decreased the risk of the bacterial endophthalmitis in experimental rabbit's model. A considerable effect of the viscoelastic material contained anti-bacterial drug can be expected as prevention of the postoperative bacterial endophthalmitis.

Keywords: endophthalmitis • antibiotics/antifungals/antiparasitics • drug toxicity/drug effects