Official ESCRS | European Society of Cataract & Refractive Surgeons


A novel in situ sustained-release drug-delivery system for infective keratitis

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Session Details

Session Title: Moderated Poster Session: A Bouquet of Topics

Venue: Poster Village: Pod 2

First Author: : L.Daniel Ponniah INDIA

Co Author(s): :    H. Anandan                       

Abstract Details


To study the efficacy of newer sustained release drug delivery system for deeper corneal infections.


A prospective interventional clinical trial at Department of Corneal Transplantation, Dr. Agarwal’s Eye Hospital, Tirunelveli, S.India


Subjects of posterior corneal infections were included. First generation implant was antimicrobial wafers. Second generation system were polymers with sustained release property. Poly (lactic-co-glycolic) acid was used to prepare the implantable antimicrobials using hot-melt extrusion method. 30mcg disc for amikacin, 100mcg disc for amphotericin B, 5mcg disc for moxifloxacin. An intrastromal bed created manually or by Femto laser, into which sustained drug delivery system was positioned. This implant was removed in 3 to 5 days. Invivo invitro correlation studies were done to predict in vivo response. Antibiogram studies were done using MIC for release kinetics in time curve.


16 cases were enrolled, 13 were primary deep corneal infections, and 2 were therapeutic DALK interfaces, 1 segmental infection in a Post DALK. 8 were fungal, 7 were bacterial, 1 was nocardial. Healing started in 1-3 days. 2 cases required reimplantation. All cases required reduced/no topical antimicrobials. No surface toxicities were noted. MIC of moxifloxacin was 0.5 μg/ml (MIC range, 0.06 to 1.0 μg/ml). MIC range was 0.03–1 μg/mL for amphotericin B. MIC range for Amikacin was 0.2 to 1 μg/ml.


This newer in situ sustained release drug delivery system showed an optimal therapeutic effect in deep corneal infections in terms of prolonged corneal contact time, enhanced ocular bioavailability, patient compliance, and reduced surface toxicities.

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