Dose and administration of intracameral moxifloxacin for prophylaxis of postoperative endophthalmitis

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• 作者：Steve A. Arshinoff ; MD ; FRCSC ; ^{ifix2is@gmail.com}Author Vitae ; Milad Modabber ; MD ; MSc
• 刊名：Journal of Cataract & Refractive Surgery
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：42
• 期：12
• 页码：1730-1741
• 全文大小：1553 K
• 卷排序：42

文摘

To review current and past practices of intracameral antibiotic administration for infection prophylaxis in cataract surgery; to review the benefits and liabilities of available prophylactic drugs, dosage determination, and administration protocols; and to devise an optimum dose and administration protocol for intracameral moxifloxacin.SettingHumber River Hospital and the University of Toronto, Toronto, Ontario, Canada.DesignRetrospective evaluation of treatment modality.MethodsThis study consisted of a detailed review of the history, drugs, and methods of intracameral prophylaxis and microbiological and pharmacodynamics analysis of options. A review of potential drug sources and doses was performed and 1 drug, dose, and administration protocol was selected. The current method's adoption reasons are described followed by the authors' experience.ResultsA single infection in 3430 cases occurred with a moxifloxacin-resistant strain of Staphylococcus epidermidis when moxifloxacin 100 mcg in 0.1 mL was used. Increasing the dose and changing the administration technique resulted in no infections in 4601 cases and no detrimental side effects or complications.ConclusionIntracameral moxifloxacin prepared by dilution of 3 cc moxifloxacin 0.5% (Vigamox) with 7 cc balanced salt solution and with the administration of 0.3 to 0.4 cc (450 to 600 mcg.) as the final step in cataract surgery via the side port after the main incision has been sealed and hydrated showed advantages over alternative intracameral antibiotic prophylactic methods, with minimum risk.Financial DisclosureNeither author has a financial or proprietary interest in any material or method mentioned.