Efficacy Of Intracameral Moxifloxacin In Prevention Of Post-Cataract Surgery Endophthalmitis: A Randomized Control Trial

To study the efficacy of intracameral moxifloxacin 0.5% in prevention of post-cataract surgery endophthalmitis 

Three tertiary eye centres of northern India

Sixty thousand cases undergoing phacoemulsification with intraocular lens (IOL) implantation were randomized in two groups in 1:1 format from January 2018 to June 2024. Group 1 received intracameral moxifloxacin (cases) while group 2 did not receive intracameral antibiotics (control). Any case of endophthalmitis in the post-operative period up to six weeks in both groups was documented and managed according to routine protocols.

Six eyes (0.02%) in intracameral moxifloxacin group developed endophthalmitis as compared to sixteen eyes in control group (0.05%) (p=0.04). The odds of developing endophthalmitis were 2.5 times lower with the usage of intracameral moxifloxacin. The mean time of presentation of endophthalmitis in group 1 and 2 were 32.26 ± 23.42 and 23.52 ± 13.91days respectively. Eight cases (8/22; 36.36%) were culture positive, of which one was fungus (n=1/8) while rest were bacteria (n=7/8). Coagulase negative Staphylococcus (CoNS) was the most common isolated micro-organism (n=4; 50%). Resistance to moxifloxacin was lower (n=2) as compared to other fluoroquinolones (n=8).

Intracameral moxifloxacin is safe and effective in preventing post-cataract surgery acute bacterial endophthalmitis.