Intracameral moxifloxacin dose and administration after posterior capsule rupture

Theme: Cataract surgery*
What: Cataract surgery
Part of: Cataract III: Innovations and research in cataract surgery / Cataracte III: 3. Innovations et recherches en chirurgie de la cataracte
When: 6/2/2024, 11:15 AM - 12:45 PM
Where: Room | Salle 801

Abstract

PURPOSE: To devise an appropriate method and dose of intracameral moxifloxacin (ICM) to prevent post-operative endophthalmitis (POE) after posterior capsule rupture (PCR) during cataract surgery. Haripriya et al., reviewing the ARAVIND experience with over two million eyes, revealed a statistically significant increase in incidence of POE after posterior capsule rupture, even after administering intracameral moxifloxacin using their currently suggested ICM protocol.

STUDY DESIGN: Literature review and mathematical modelling

METHODS: We adapted our previous mathematical ICM injection model for standard cataract surgery to the unique parameters of PCR. In the revised model, we determined a revised administration method and dose of ICM, such that the risk of POE after PCR can be lowered to be more similar to after uncomplicated cataract surgery.

RESULTS: Once PCR occurs, the effective volume of the space requiring antibacterial prophylaxis expands, thus requiring an increased corrected ICM dose for prophylaxis.  Furthermore, in cases where a PC IOL is placed, its positioning has an effect on the distribution of ICM, and therefore its prophylactic efficacy. Different possible scenarios were studied and a method to enhance current results including all studied scenarios was arrived at.

CONCLUSION: The dose and administration of ICM can be modified in the event of PCR to reduce the risk of POE, without risking drug toxicity. The dose and administration recommendation will be explained. Generally, a two-step injection of low dose moxifloxacin (150 mg per 0.1 mL) is advised and will be explained in detail.

Presenter(s)

Presenting Author: Steve Arshinoff

Additional Author(s):

Runjie Bill Shi, Temerity Faculty of Medicine, University of Toronto

Brendan K. Tao, Faculty of Medicine, UBC

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