Journal of cataract and refractive surgery · 2026
Efficacy of intracameral moxifloxacin in prevention of postcataract surgery endophthalmitis: randomized control trial.
СтатьяРандомизированное исследованиеМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Sharma Namrata, Sen Alok, Sharma Mohita, Bari Aafreen, Shakkarwal Chetan, Maharana Prafulla Kumar, Agarwal Tushar, Dada Tanuj, Gaur Sandhya, Joshi Rajesh, Das Sandhya A, Upadhyay Ashish Dutt, Titiyal Jeewan Singh
Аннотация
PURPOSE: To study the efficacy of intracameral moxifloxacin 0.5% in prevention of postcataract surgery endophthalmitis.
SETTINGS: 3 tertiary eye centers of northern India.
DESIGN: Multicentric randomized clinical study.
METHODS: 60 000 eyes undergoing phacoemulsification with intraocular lens (IOL) implantation were randomized in 2 groups in 1:1 format from January 2018 to June 2024. Group 1 received intracameral moxifloxacin (cases), whereas group 2 did not receive intracameral antibiotics (control). Any case of endophthalmitis in the postoperative period up to 6 weeks in both groups was documented and managed according to routine protocols.
RESULTS: The endothelial cell counts were comparable preoperatively ( P = .18) and postoperatively ( P = .54). 6 eyes (0.02%) in the intracameral moxifloxacin group developed endophthalmitis as compared with 16 eyes in the control group (0.05%) ( P = .04). The odds of developing endophthalmitis were 2.5 times lower with the usage of intracameral moxifloxacin. The mean time of presentation of endophthalmitis in groups 1 and 2 was 32.26 ± 23.42 days and 23.52 ± 13.91 days, respectively. 8 cases (8/22; 36.36%) were culture-positive of which one was fungus (n = 1/8; 12.5%), while rest were bacteria (n = 7/8; 87.5%). Coagulase-negative Staphylococcus was the most commonly isolated microorganism (n = 4; 50%). Resistance to fluoroquinolones was higher for ciprofloxacin (5/7) and gatifloxacin (3/7) than moxifloxacin (2/7). At 3 months, 17 of 22 eyes (77.27%) responded to treatment and endophthalmitis resolved by 3 months. However, 1 eye in group 1 and 3 eyes in group 2 developed phthisis (4/22; 18.18%).
CONCLUSIONS: Intracameral moxifloxacin is safe and effective in preventing postcataract surgery acute bacterial endophthalmitis.
SETTINGS: 3 tertiary eye centers of northern India.
DESIGN: Multicentric randomized clinical study.
METHODS: 60 000 eyes undergoing phacoemulsification with intraocular lens (IOL) implantation were randomized in 2 groups in 1:1 format from January 2018 to June 2024. Group 1 received intracameral moxifloxacin (cases), whereas group 2 did not receive intracameral antibiotics (control). Any case of endophthalmitis in the postoperative period up to 6 weeks in both groups was documented and managed according to routine protocols.
RESULTS: The endothelial cell counts were comparable preoperatively ( P = .18) and postoperatively ( P = .54). 6 eyes (0.02%) in the intracameral moxifloxacin group developed endophthalmitis as compared with 16 eyes in the control group (0.05%) ( P = .04). The odds of developing endophthalmitis were 2.5 times lower with the usage of intracameral moxifloxacin. The mean time of presentation of endophthalmitis in groups 1 and 2 was 32.26 ± 23.42 days and 23.52 ± 13.91 days, respectively. 8 cases (8/22; 36.36%) were culture-positive of which one was fungus (n = 1/8; 12.5%), while rest were bacteria (n = 7/8; 87.5%). Coagulase-negative Staphylococcus was the most commonly isolated microorganism (n = 4; 50%). Resistance to fluoroquinolones was higher for ciprofloxacin (5/7) and gatifloxacin (3/7) than moxifloxacin (2/7). At 3 months, 17 of 22 eyes (77.27%) responded to treatment and endophthalmitis resolved by 3 months. However, 1 eye in group 1 and 3 eyes in group 2 developed phthisis (4/22; 18.18%).
CONCLUSIONS: Intracameral moxifloxacin is safe and effective in preventing postcataract surgery acute bacterial endophthalmitis.