Abstract
Purpose :
The purpose of our study is to describe a series of three patients without prior history of corneal dystrophy or dysfunction who experienced transient corneal edema shortly follwoing uneventful cataract extraction with the use of intracameral moxifloxacin.
Methods :
We performed a literature review to examine the incidence and known etiologies of post phacoemulsification corneal edema. Additionally, we reviewed the literature evaluating the safety profile of intracameral moxifloxacin. A chart review was conducted on three patients (n=3) who were referred to two corneal specialists after experiencing corneal edema of unidentifiable etiology 1-week status post cataract extraction done by three different experienced surgeons.
Results :
All three patients had healthy corneas preoperatively. They all had clear corneas post-operative day 1. These patients also had clear corneas 1-month post-op. The edema was focal and not diffuse. Cell counts in some cases showed absence of endothelial cells in the involved area without presence of Descemet’s detachment. What was noted to be similar in all three cases was that they each received intracameral moxifloxacin 0.05% during their surgery. The formulation for the injection included moxifloxacin HCl 0.00525gm, sodium chloride 0.0061gm and sodium hydroxide 10% (w/v) water.
Conclusions :
Though our series does not prove that moxifloxacin caused these patients’ edema, it sheds light on the possibility that intracameral moxifloxacin may not be as benign as once thought. Though prior studies may not have found statistically significant difference in the incidence of post-operative corneal edema with use of intracameral moxifloxacin, their studies may not have been powered to do this. Our small series suggests that intracameral moxifloxacin for prevention of endophthalmitis may not be suitable for every patient and that this should be tailored to appropriate patients including those with pre-existing endothelial dysfunction.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.