Japanese Survey of Prophylactic Intracameral Moxifloxacin Injection

Friday, April 25, 2014
KIOSKS (Boston Convention and Exhibition Center)
Shin-ichi Sasaki, MD, Tottori university, Tottori, Japan
Kazuki Matsuura, MD, Nojima Hospital, Kurayoshi-City, Tottori, Japan
Yoshitsugu Inoue, MD, PhD, Tottori University, Yonago, Japan

Narrative Responses:

Purpose
To report the rates of postcataract surgery endophthalmitis and the incidence of complications following intracameral moxifloxacin (MFLX) injection.

Methods
Twenty-one clinics in institutions that administered intracameral MFLX injection in Japan was retrospectively surveyed. The number of surgeries and endophthalmitis cases in the past 4 years, before and after the introduction of intracameral MFLX, was investigated. This survey was conducted by mail or interview in February 2013.

Results
All institutions employed total replacement of aqueous chamber by moxifloxacin solution rather than small-volume injection. Before and after intracameral MFLX administration, the number of endophthalmitis cases occurred within one month of surgery was 8/17,485 (i.e., 1/2,186) cases and 3/23,501(i.e., 1/7,834) cases, respectively. At three institutions, 50–100 μg/mL-MFLX; at nine institutions, 100–300 μg/mL-MFLX; and at nine institutions, 500 μg/mL-MFLX was administered. The highest concentration (500 μg/mL) was administered in 20,020cases.

Conclusion
Intracameral MFLX (50–500 μg/mL) administration decreased the risk of endophthalmitis by 3.6 fold. Among >23,000 cases MFLX administration ≤500 μg/mL did not result in any severe complications, such as toxic anterior segment syndrome or corneal endothelial cell loss.