2003 OMIG, Abstract 9

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The Effect of Cataract Surgery on Ocular Levels of Topical Moxifloxacin
Rookaya Mather^1,2, Jay Stewart², Tisha Prabriputaloong^1,2, Stephen D. McCleod^1,2. ¹Francis I. Proctor Foundation, San Francisco, ²Cornea Service, Department of Ophthalmology, University of California, San Francisco

Purpose: To investigate the effect of cataract surgery on the concentration of moxifloxacin in the aqueous and vitreous after topical application in a rabbit model.
Design: A prospective laboratory intervention design using a rabbit model to study the effect of cataract surgery on the ocular concentrations of topically-administered moxifloxacin in operated eyes vs. non-operated eyes.
Methods: Following the administration of topical 0.5% moxifloxacin, 60 minutes before surgery and immediately post-cataract surgery, aqueous and vitreous humors were sampled at 30, 60 and 120 minutes post-surgery. Moxifloxacin concentrations were determined by High Pressure Liquid Chromatography and mean tissue concentrations obtained in surgical eyes were compared to the concentrations obtained in non-surgical control eyes. The potential effectiveness of moxifloxacin in providing prophylaxis against intracameral bacterial inoculation was investigated by comparing antibiotic concentrations measured over the first two hours after surgery to Minimum Inhibitory Concentration values for S. aureus and S. epidermidis.
Results: In surgical eyes moxifloxacin concentrations in aqueous, were 13.88, 16.18 and 12.18µg/ml vs. 25.32, 32.64 and 15.69µg/ml in non-operated eyes at 30, 60 and 120 minutes, respectively. No statistically significant differences were found when surgical and non-surgical eyes were compared. In surgical eyes moxifloxacin concentrations in vitreous, were 66.84, 66.62 and 400.23ng/ml vs. 43.09, 199.80 and 54.44ng/ml in non-operated eyes at 30, 60 and 120 minutes, respectively. No statistically significant differences were found when surgical and non-surgical eyes were compared.
Conclusions: Cataract surgery does not substantially alter the penetration of topical antibiotics compared to the un-operated eye. In the case of moxifloxacin, as indicated by this model, a multiple drop dosing schedule produced aqueous concentrations that were well above the Minimum Inhibitory Concentrations of even resistant strains of the most common organisms implicated in post-cataract endophthalmitis.

Financial Support: Unrestricted research grant from Alcon Pharmaceutical, Fort Worth Texas. The authors have no proprietary interest in any of the products presented in this study.

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