Efficacy and safety of prophylactic intracameral moxifloxacin injection in Japan

J Cataract Refract Surg. 2013 Nov;39(11):1702-6. doi: 10.1016/j.jcrs.2013.05.036. Epub 2013 Sep 18.

Abstract

Purpose: To report endophthalmitis rates after cataract surgery and the incidence of complications after intracameral moxifloxacin injection.

Setting: Nineteen clinics in Japanese institutions.

Design: Retrospective survey cohort study.

Methods: The number of surgeries and endophthalmitis cases in the past 4 years before and after the introduction of intracameral moxifloxacin was evaluated. The survey was performed by mail or interview in February 2013.

Results: All institutions used total-replacement administration rather than small-volume injection. At 3 institutions, 50 to 100 μg/mL moxifloxacin; at 9 institutions, 100 to 300 μg/mL moxifloxacin; and at 7 institutions, 500 μg/mL moxifloxacin was administered. The highest concentration (500 μg/mL) was administered in 14,124 cases. Endophthalmitis cases occurred 1 month or sooner postoperatively in 8 of 15,958 cases (ie, 1 in 1955) without intracameral moxifloxacin administration and in 3 of 18,794 cases (ie, 1 in 6265) with intracameral moxifloxacin administration.

Conclusions: Intracameral moxifloxacin (50 to 500 μg/mL) administration decreased the risk for endophthalmitis by 3-fold. In more than 18,000 cases, moxifloxacin administration of 500 μg/mL or less did not result in severe complications, such as toxic anterior segment syndrome or corneal endothelial cell loss.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Anterior Chamber / drug effects*
  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / therapeutic use*
  • Aza Compounds / adverse effects
  • Aza Compounds / therapeutic use*
  • Cohort Studies
  • Endophthalmitis / microbiology
  • Endophthalmitis / prevention & control*
  • Eye Infections, Bacterial / microbiology
  • Eye Infections, Bacterial / prevention & control*
  • Fluoroquinolones
  • Health Surveys
  • Humans
  • Injections, Intraocular
  • Japan
  • Lens Implantation, Intraocular*
  • Moxifloxacin
  • Phacoemulsification*
  • Quinolines / adverse effects
  • Quinolines / therapeutic use*
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Aza Compounds
  • Fluoroquinolones
  • Quinolines
  • Moxifloxacin