March 2019

RESIDENTS

Safety and efficacy of intracameral moxifloxacin for prevention of post-cataract endophthalmitis: a randomized controlled clinical trial


Mathias Melega, MD, Monica Alves, PhD, Rodrigo Pessoa Cavalcanti Lira, PhD, Iuri Cardoso da Silva, MD, Bruna Gil Ferreira, MD, Hermano Assis Filho, MD, Fernando Rodrigo Pedreira Chaves, PhD, Alexandre Martini, MD, Livia Maria Dias Freire, MD, Roberto dos Reis, MD, Carlos Eduardo Leite Arieta, PhD

J Cataract Refract Surg. 2019;45(3):343–350.

Purpose: To evaluate the safety and efficacy of intracameral (IC) 0.5% moxifloxacin in the prevention of post-cataract endophthalmitis.
Setting: University of Campinas, Campinas, Sao Paulo, Brazil
Design: Prospective, randomized, partially masked, single-site clinical trial
Methods: A total of 3,640 eyes from 3,640 patients who underwent phacoemulsification were randomized into two groups in block sizes of 4. Group A consisted of 1,818 patients who received an IC injection of 0.03 mL (150 µg) of undiluted 0.5% moxifloxacin at the end of surgery. Group B consisted of 1,822 patients who received no IC medication. The postoperative prescription for both groups consisted of 0.5% moxifloxacin and 0.1% dexamethasone. Patients were monitored for 6 weeks after surgery. The primary outcome was the incidence of acute endophthalmitis in each group. Secondary outcomes were best corrected visual acuity (BCVA), endothelial cell density (ECD), intraocular pressure (IOP), and central corneal thickness (CCT).
Results: The incidence of endophthalmitis within 6 weeks of follow up was 1 out of 1,818 eyes (0.05%) in the moxifloxacin group and 7 out of 1,822 eyes (0.38%) in the control group (p=0.035). There was no significant difference in BCVA (p=0.202), ECD (p=0.482), IOP (p=0.105), or CCT (p=0.558). No ocular or systemic study-related adverse events were observed.
Conclusions: The IC injection of undiluted 0.5% moxifloxacin can be safely applied as the last step of phacoemulsification. It was found to be effective in reducing the risk of endophthalmitis. This study represents the first controlled randomized clinical trial to evaluate the safety and efficacy of IC moxifloxacin in the prevention of post-cataract endophthalmitis.

Safety and efficacy of intracameral moxifloxacin for prevention of post-cataract endophthalmitis: a randomized controlled clinical trial Safety and efficacy of intracameral moxifloxacin for prevention of post-cataract endophthalmitis: a randomized
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2019-03-05T07:57:56Z
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