Intracameral Use Of Off Label Moxifloxacin Eye Drop After Phacoemulsification And Foldable Iol Surgery (Pke+ Fiol)

to evaluate safety and efficacy of intracameral use of commercially available moxifloxacin eye drop of multiple brands following uncomplicated PKE+ FIOL surgery.

multiple studies have recommended the use of intracameral antibiotic after cataract surgery for prevention of complications like endophthalmitis. However, brands like vigamox (Novartis) and dispensing pharmacy may not be available for use in all the countries.  Locally available brands of moxifloxacin has to be used frequently specially in smaller clinics. Efficacy and safety of few commercially available brands and dispensing in the OT was studied.

: 200 eyes(200 patients) were studied. January, 2022-January, 2023. A prospective randomized study. PKE +FIOL was done by a single surgeon. Mean age: 63 yrs. M=128,F=72. Inclusion-NS grade III & IV. Exclusion-H/o uveitis & trauma, small pupil, PPC,complicated surgery. Pre & post operative VA, IOP, slit-lamp,fundus examination, AS OCT of AC were done. Patients were divided into 4 groups. Each group-50 pts(50 Eyes). Each eye received intracameral moxifloxacin made from 4 different commercial brands of eye drops.

After completion of surgery, 0.1 ml of diluted moxifloxacin was injected into the capsular bag and AC through the side port. Moxifloxacin Solution was made in the OT before injection(0.1 ml moxifloxacin with 0.4 ml of distilled water).

200 eyes of 200 patients were studied. In group A- 1, group B- 1, group C- 2 and in group D- 2 eye had developed mild to moderate degree of fibrin reaction within 1- 5 days after surgery. Pain- 6 patients, irritation- 6 patients, watering- 4 patients and dimness of vision in 6 patients. Patients were treated with frequent antibiotic + steroid and cyclopentolate eye drop. Symptom resolved within 7-10 days in all 6 patients(6 eyes). Final VA was 6/6 -6/9 (6 eyes). Relative risk 5.0000, 95 % CI, significance level p=0.295. No patient had developed endophthalmitis during 6 weeks follow up in our study. 

in this prospective randomized study(n=200) commercially available (of multiple brands,n=4) moxifloxacin eye drop was found to be safe and effective while preventing complications like endophthalmitis. Off label use of moxifloxacin was not associated with TASS. A larger study is needed involving more number of patients and brands of moxifloxacin to arrive at a final conclusion.