Intracameral moxifloxacin after routine cataract surgery appears safe

This retrospective review of 141 consecutive patients (200 eyes) who had cataract surgery at a private practice found that intracameral injection of moxifloxacin (Vigamox, Alcon, Inc., Hünenberg, Switzerland) diluted to a 0.1% solution in a 100 µg/0.1 mL dose at the conclusion of surgery resulted in no adverse effects. A comparison of these patients with 50 patients (100 eyes) who underwent cataract surgery at this practice before the implementation of an intracameral moxifloxacin protocol found that aqueous cell counts were significantly lower one day after surgery in the moxifloxacin-treated group.

Additionally, the author prospectively evaluated by optical coherence tomography (OCT) 31 of the moxifloxacin-treated eyes before surgery and six weeks after surgery. The changes measured in macular thickness and volume were comparable to those found in other studies in which an intracameral antibiotic was not given. The author concluded that intracameral moxifloxacin injection at the end of routine cataract surgery may prove to be a useful modality in evolving prophylactic regimens against postoperative endophthalmitis.

The author further noted that in a poster presented at the ASCRS Symposium on Cataract, IOL and Refractive Surgery in April 2007, Steve A. Arshinoff, MD, described his experience using intracameral moxifloxacin injection as part of a prophylactic regimen during cataract surgery in a series of 1500 patients. No adverse effects were attributed to the injection, a 0.1 mg intracamerally administered dose of moxifloxacin solution diluted in a balanced salt solution to a 50 or 100 μg/0.1 cc concentration. Also there were no cases of endophthalmitis identified among these patients.

Financial Disclosures
Dr. Singer is a consultant to Bausch and Lomb.