Ocular Microbiology and Immunology Group
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2016 OMIG Abstract 13

A Single Thermo-Responsive Drop Containing Microspheres Loaded with Moxifloxacin Prevents Endophthalmitis in a Rabbit Model
Eric G Romanowski, Alex Mammen, Morgan V Fedorchak, Deepinder K Dhaliwal,
Robert MQ Shanks, and Regis P Kowalski
The Charles T Campbell Ophthalmic Microbiology Laboratory, UPMC Eye Center, Ophthalmology and Visual Science Research Center, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

Introduction: Post-surgical endophthalmitis is a sight-threatening problem. We introduce an approach of endophthalmitis prevention by applying a single application of a thermo-responsive drop containing controlled-release microspheres loaded with moxifloxacin in a rabbit endophthalmitis prevention model. This drop is a liquid at room temperature when instilled into the cul-de-sac and becomes a solid after placement. The drop conforms to the shape of the cul-de-sac and can remain in place for days to weeks.

Methods: Using a one-eye design, 24 rabbits were separated into 3 treatment groups: 1) a single drop containing controlled-release moxifloxacin loaded microspheres was placed into the conjunctival cul-de-sac; 2) a single drop containing blank microspheres (without moxifloxacin) was placed into the conjunctival cul-de-sac; and 3) topical treatment with 0.5% moxifloxacin (Vigamox®) drops every 15 minutes for 1 hour. All rabbits were challenged with anterior chamber injections of Staphylococcus aureus one hour after drop placement and immediately after the fifth topical dose of 0.5% moxifloxacin. Rabbits in the topical 0.5% moxifloxacin group were also treated immediately after challenge and four additional times over the next 24 hours. After 24 hours, the rabbits were clinically evaluated for endophthalmitis and the animals were euthanized to culture for intraocular Staphylococcus aureus. The treatment groups were compared statistically for bacterial endophthalmitis.

Results: No eyes developed endophthalmitis, based on clinical presentation and/or positive culture, in the groups treated with the thermo-responsive drop containing controlled-release moxifloxacin loaded microspheres (0/8, 0%) or topical 0.5% moxifloxacin (0/8, 0%). Eight of 8 eyes (100%) developed endophthalmitis in the control group eyes treated with thermo-responsive drops containing blank microspheres. The different outcomes were statistically significant (p=0.0001).

Conclusion: A single thermo-responsive drop containing controlled-release moxifloxacin loaded microspheres was successful in preventing endophthalmitis in a rabbit endophthalmitis prevention model. Further clinical studies are required to confirm the potential of thermo-responsive drops containing controlled-release antibiotic loaded microspheres to prevent post-surgical ocular infections.

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