Intracameral moxifloxacin after cataract surgery: a prospective study

Objective: To study the safety parameters associated with intracameral moxifloxacin application five weeks after cataract surgery. Methods: The study was a prospective case series set in a private hospital in Recife, Pernambuco, Brazil. A consecutive sample of 1,016 cataract surgeries was evaluated. The inclusion criteria were patients with indications for cataract surgery, a minimum of 55 years of age, and no history of allergy to quinolones. Patients were prepared for surgery using a 5% povidone solution diluted as a topical antiseptic agent. The operative technique was phacoemulsification with intraocular lens implantation. A 0.3-mL syringe was partially filled with moxifloxacin and 150 mu g/0.03 mL of moxifloxacin was administered through the surgical incision at the end of the surgery. Postoperatively, patients were prescribed: (1) 0.5% moxifloxacin eyedrops 5 times daily for 1 week, and (2) 1% prednisolone acetate eyedrops 5 times daily for 1 week, followed by 4 times daily for 1 week and, subsequently, 2 times daily for 3 weeks. The outcomes were incidence of acute endophthalmitis, mean changes from baseline to 5 postoperative weeks in corneal endothelial cell density, corrected distance visual acuity and intraocular pressure. Results: The mean age was 67 +/- 5 years, and 56.2% of the patients were female. There were no cases of endophthalmitis. The mean preoperative corrected distance visual acuity was 58 letters +/- 10 (SD), and the mean postoperative corrected distance visual acuity was 80 letters +/- 4 (SD). The mean change in corneal endothelial cell density was 249 cells/mm (-10.3%). There was almost no difference in intraocular pressure. No study-related adverse events were observed. Conclusion: The results suggest moxifloxacin is a safe option for intracameral use after cataract surgery.