Ocular Microbiology and Immunology Group
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2015 OMIG Abstract 14

Intracameral Cross-Linked Hyaluronic Acid Plus Vancomycin—Sustained Release and the First Step Towards Effective Dropless Eye Surgery
Richard A. Eiferman, M.D., F.A.C.S.  University of Louisville
Dale P. DeVore, PHD

PURPOSE:  While intracameral antibiotic injections have been advocated as prophylaxis against endophthalmitis, they are quickly diluted by fresh aqueous humor as well as lost via outflow through the trabecular meshwork.  We have devised a unique method to cross-link hyaluronic acid that traps antibiotic in a “molecular cage”.  This provides a biodegradable slow release delivery system that delivers vancomycin at bacteriocidal levels for 72 hours.
METHOD:  Hyaluronic acid is cross-linked by a novel process, 1 mg of fluoroscein tagged vancomycin is added.  This immediately forms a small viscoelastic droplet which contains the antibiotic.  The mixture is placed in 1 cc normal saline and aliquots are withdrawn at 1, 6, 12, 24, 48 and 72 hours.  The studies were done in triplicate.  Vancomycin levels were measured in a fluorometer at each time point.
RESULTS:  The cross-linked hyaluronic acid containing vancomycin slowly hydrolyzed releasing the antibiotic.  At one hour, the vancomycin measured 225 ug.  At 6 and 12 hours, the vancomycin averaged 100 ug. At 24 hours, the vancomycin averaged 70 ug; at 48 hours, the vancomycin levels averaged 50 ug and at 72 hours, the vancomycin levels averaged 35 ug.  At all time points, the vancomycin was above bacteriocidal levels for most pathogens.
CONCLUSION:  The use of cross-linked hyaluronic acid can provide a sustained release of medication. When placed in the anterior chamber, this method may eliminate the need for patients to self administer post operative antibiotic eye drops.
AAO Disclosure Code: P

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