Posters

Intracameral moxifloxacin vs levofloxacin: postoperative outcomes in patients undergoing phacoemulsification with in-the-bag intraocular lens implantation

Poster Details

First Author: H.Uy PHILIPPINES

Co Author(s):    R. Nepomuceno   F. Cruz   C. Rubio   P. Chan           

Abstract Details

Purpose:

Endophthalmitis remains a rare but potentially devastating complication of cataract surgery. Chemoprophylaxis against bacterial endophthalmitis has largely been via topical or subconjunctival antibiotics administered before surgery. However, recent evidence supports the safety and efficacy of using intracameral administration of antibiotics in preventing postoperative endophthalmitis. Recent years have witnessed increased utilization of 3rd and 4th generation fluoroquinolones to counteract resistance to 2nd generation agents. However, data on patient outcomes from our region remains limited. Our study evaluated patient outcomes associated with the use of either intracameral moxifloxacin or levofloxacin in patients undergoing phacoemulsification and IOL implantation.

Setting:

Peregrine Eye and Laser Institute, Makati City, Philippines

Methods:

Open-label, randomized clinical trial. We included 104 eyes with senile cataracts and no other ocular pathology, who underwent phacoemulsification with in-the-bag intraocular lens implantation and were randomized to receive either intracameral unpreserved levofloxacin, 0.5mg in 0.1ml (Levofloxacin group) or moxifloxacin 0.5mg in 0.1ml (Moxifloxacin group). Eyes were evaluated preoperatively for cataract density, signal strength, central retinal thickness (CRT), retinal volume, endothelial cell density (ECD) and corneal thickness (pachymetry). Follow-up assessments were performed at day 1, week 1 and month 1 postoperative time points. Statistically significant differences between the means of the two treatment groups were determined using Student’s t-test.

Results:

Baseline parameters were similar between the Levofloxacin (n=52) and Moxifloxacin (n=52) groups. Mean CRT (SD) in the moxifloxacin and levofloxacin groups were 244.55µm (24.658), 246.86µm (22.009) at day 1; 250.9µm (27.413) and 251.39µm (22.013) at week 1; 262.24µm (35.830) and 261.39µm (24.567) at month 1, postoperatively. Mean retinal volumes (SD) were 9.396 (0.591) and 9.339 (0.728) on day 1; 9.698 (0.630) and 9.545 (0.836) at week 1; 9.992 (0.643) and 9.778 (0.735) at month 1 in the moxifloxacin and levofloxacin groups, respectively. No significant differences in postoperative ECD and corneal thickness were observed.

Conclusions:

In patients undergoing phacoemulsification with in-the-bag intraocular lens implantation, intracameral moxifloxacin and levofloxacin have similar postoperative outcomes.

Financial Disclosure:

research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented