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class=""h4"">Purpose
To determine whether the addition of a bioadhesive drug-delivery system to topi
cal azithromy
cin indu
ces intrao
cular inflammation and damage when introdu
ced intrao
cularly by different approa
ches and in varying doses.
class=""h4"">Setting
John A. Moran Eye Center, Salt Lake City, Utah, USA.
class=""h4"">Design
Experimental study.
class=""h4"">Methods
Commercial topical azithromycin 1.0 % was duplicated, including the benzalkonium chloride, but without inclusion of the Durasite bioadhesive drug-delivery system. Injections of 50?¦ÌL, 25 ¦ÌL, and 10 ¦ÌL of the antibiotic solutions were administered in a masked fashion to 2 rabbits; 1 eye (study eye) in each rabbit was randomized to receive azithromycin with the delivery system and the fellow eye (control eye) to receive azithromycin without the delivery system. Two rabbits had topical drops of each solution placed after a 2.8 mm incision was created. Masked slitlamp examinations, pachymetry, and intraocular pressure (IOP) were determined 1 day and 2 days postoperatively. The animals were humanely killed, and the endothelial density and histopathology were examined.
class=""h4"">Results
The IOP (P<.001), pachymetry (P<.001), and signs of inflammation (P=.38 to .003) were consistently higher in the study eye, especially at the 50 ¦ÌL dose, than in the control eye. This was confirmed by histopathology.
class=""h4"">Conclusion
If the drug-delivery system gains access to the anterior chamber, it may cause substantial corneal edema and inflammation, even at low doses and after topical administration.
class=""h4"">Financial Disclosure
No author has a financial or proprietary interest in any material or method mentioned.
