American Journal of Ophthalmology
Volume 138, Issue 4 , Pages 554-559, October 2004

The effect of cataract surgery on ocular levels of topical moxifloxacin

Data from this article were presented in part at the Ocular Microbiology and Immunology Group meeting, in Anaheim, California, November 2003.

  • Rookaya Mather, MD

      Affiliations

    • From the Department of Ophthalmology, University of California, San Francisco, California; and the Francis I. Proctor Foundation for Research in Ophthalmology. Dr. Mather is now affiliated with the University of Western Ontario, Department of Ophthalmology, London, Ontario, Canada. Department of Ophthalmology (R.M.), University of Western Ontario, London, Ontario, Canada
    • ,
  • Jay M. Stewart, MD

      Affiliations

    • Francis I. Proctor Foundation for Research in Ophthalmology (J.M.S., T.P., J.W., S.D.M.)
    • ,
  • Tisha Prabriputaloong, MD

      Affiliations

    • Francis I. Proctor Foundation for Research in Ophthalmology (J.M.S., T.P., J.W., S.D.M.)
    • Cornea Service of the Department of Ophthalmology (T.P., S.D.M.), University of California, San Francisco, California, USA
    • ,
  • Joshua Wong, MS

      Affiliations

    • Francis I. Proctor Foundation for Research in Ophthalmology (J.M.S., T.P., J.W., S.D.M.)
    • ,
  • Stephen D. McLeod, MD

      Affiliations

    • Francis I. Proctor Foundation for Research in Ophthalmology (J.M.S., T.P., J.W., S.D.M.)
    • Cornea Service of the Department of Ophthalmology (T.P., S.D.M.), University of California, San Francisco, California, USA
    • Corresponding Author InformationInquiries to Stephen D. McLeod, MD, Department of Ophthalmology, University of California, San Francisco, K-301, Box 0730, 10 Kirkham St., San Francisco, CA, 94143, Phone: 415-502-5195, Fax: 415-476-2896

Accepted 12 May 2004. published online 16 September 2004.

Purpose

To investigate the effect of cataract surgery on the concentration of moxifloxacin in aqueous and vitreous humor after topical application.

Design

Prospective laboratory intervention using a rabbit model.

Methods

Following topical administration of 0.5% moxifloxacin, 60 minutes before surgery and immediately post cataract surgery, aqueous and vitreous humor were sampled at 30, 60, and 120 minutes postsurgery. Moxifloxacin concentrations were determined by high-pressure liquid chromatography (HPLC). Mean tissue concentrations obtained in surgical eyes were compared with concentrations obtained in nonsurgical eyes. The potential effectiveness of moxifloxacin in providing prophylaxis against intracameral bacterial inoculation was investigated by comparing antibiotic concentrations to minimum inhibitory concentration (median MIC90) values for Staphylococcus aureus and Staphylococcus epidermidis.

Results

In surgical eyes, mean moxifloxacin concentrations in aqueous were 13.9, 16.2, and 12.2 μg/ml versus 25.3, 32.6, and 15.7 μg/ml in nonoperated eyes at 30, 60, and 120 minutes, respectively. No statistically significant differences were found between surgical and nonsurgical eyes. In surgical eyes, mean moxifloxacin concentrations in vitreous were 66.8, 66.6, and 400.2 ng/ml versus 43.1, 199.8, and 54.4 ng/ml in nonoperated eyes at 30, 60, and 120 minutes, respectively. These differences were not statistically significant.

Conclusions

There were no statistically significant differences in the penetration of topical moxifloxacin in eyes undergoing cataract surgery compared with unoperated eyes. A multiple-drop schedule of moxifloxacin produced aqueous concentrations that were well above the MICs of even resistant strains of the most common organisms implicated in postcataract surgery endophthalmitis.

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 Supported by an unrestricted research grant from Alcon Pharmaceutical, Fort Worth, Texas.This study was also supported by an unrestricted grant from Research to Prevent Blindness Inc., New York New York.

 Drs. McLeod and Mather have received consulting fees from Alcon Pharmaceutical, Fort Worth, Texas.

PII: S0002-9394(04)00530-6

doi:10.1016/j.ajo.2004.05.011

American Journal of Ophthalmology
Volume 138, Issue 4 , Pages 554-559, October 2004

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