Postoperative Safety Outcomes in Patients Undergoing Routine Phacoemulsification Cataract Surgery with Intraoperative Intracameral Injection of Preservative-Free Moxifloxacin versus Levofloxacin
Franz Marie Cruz1,2, Harvey S. Uy1,2, Carlo Josemaria Rubio1, Pik Sha Chan1
1Peregrine Eye and Laser Institute, Makati City, Philippines
2Department of Ophthalmology and Visual Sciences, University of the Philippines – College of Medicine, Philippine General Hospital, Manila, Philippines
Correspondence: Harvey S. Uy
Peregrine Eye and Laser Institute, Morning Star Center , 347 Jupiter Street, Bel-Air, Makati City, Philippines, 1209
Tel: + 63 2 8890 0115, Fax: +63 2 8241 1153
Disclosure: Harvey S. Uy has received research funding from Santen, Inc. The other authors report no conflicts of interest in this work.
Purpose: This study compared the safety outcomes of two intracameral fluoroquinolone antibiotics, moxifloxacin and levofloxacin, as prophylaxis treatment in eyes that underwent uncomplicated cataract surgery.
Methods: This is a prospective, double-masked, randomized, interventional, single-center clinical trial. Eyes with visually-significant cataracts underwent phacoemulsification and received preservative-free intracameral 0.5% moxifloxacin [58 eyes (M group)] or 0.5% levofloxacin [56 eyes (L group)] at the end of the surgery as antibiotic prophylaxis. The following safety parameters were evaluated postoperatively at Day 1, Week 1 and Month 1: central retinal thickness (CRT), macular volume (MV), central corneal thickness (CCT), and endothelial cell density (ECD). In-between group comparison was made at each of the 4 study visits using Student’s t-test.
Results: Both M and L groups had similar baseline characteristics. There were no significant differences in CRT, MV, CCT and ECD between the 2 groups at each time point in the study. There were no significant differences in the mean changes in CRT, MV, CCT and ECD from baseline to final visit between the 2 groups. No study-related adverse events were observed during the study period.
Conclusion: Intracameral application of preservative-free 0.5% moxifloxacin and 0.5% levofloxacin appear to have similar safety outcomes when used as antibacterial prophylaxis among eyes undergoing cataract surgery. Based on the results, both fluoroquinolone agents are potentially suitable options for endophthalmitis chemoprophylaxis.
Keywords: Levofloxacin, Moxifloxacin, Fluoroquinolone, Cataract surgery, Endophthalmitis prophylaxis
Philipp J Ophthalmol 2022;47:15-22