Efficacy and safety of prophylactic intracameral moxifloxacin injection in Japan.
OBJECTIVE
To report endophthalmitis rates after cataract surgery and the incidence of complications after intracameral moxifloxacin injection.


METHODS
Nineteen clinics in Japanese institutions.


METHODS
Retrospective survey cohort study.


METHODS
The number of surgeries and endophthalmitis cases in the past 4 years before and after the introduction of intracameral moxifloxacin was evaluated. The survey was performed by mail or interview in February 2013.


RESULTS
All institutions used total-replacement administration rather than small-volume injection. At 3 institutions, 50 to 100 μg/mL moxifloxacin; at 9 institutions, 100 to 300 μg/mL moxifloxacin; and at 7 institutions, 500 μg/mL moxifloxacin was administered. The highest concentration (500 μg/mL) was administered in 14,124 cases. Endophthalmitis cases occurred 1 month or sooner postoperatively in 8 of 15,958 cases (ie, 1 in 1955) without intracameral moxifloxacin administration and in 3 of 18,794 cases (ie, 1 in 6265) with intracameral moxifloxacin administration.


CONCLUSIONS
Intracameral moxifloxacin (50 to 500 μg/mL) administration decreased the risk for endophthalmitis by 3-fold. In more than 18,000 cases, moxifloxacin administration of 500 μg/mL or less did not result in severe complications, such as toxic anterior segment syndrome or corneal endothelial cell loss.
From Nojima Hospital (Matsuura) and Tottori University (Inoue), Tottori, the Miyoshi Eye Center (Miyoshi), Hiroshima, the Tokyo Women's Medical University (Suto), Tokyo, and the Kushimoto Rehabilitation Center (Akura), Wakayama, Japan. Electronic address: i-mnys2001@za.ztv.ne.jp.
Kazuki
K
Matsuura
Teruyuki
T
Miyoshi
Chikako
C
Suto
Junsuke
J
Akura
Yoshitsugu
Y
Inoue
D000867:Anterior Chamber / Q000187:drug effects*; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001372:Aza Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D015331:Cohort Studies; D009877:Endophthalmitis / Q000382:microbiology / Q000517:prevention & control*; D015818:Eye Infections, Bacterial / Q000382:microbiology / Q000517:prevention & control*; D024841:Fluoroquinolones; D006306:Health Surveys; D006801:Humans; D056965:Injections, Intraocular; D007564:Japan; D019654:Lens Implantation, Intraocular; D000077266:Moxifloxacin; D018918:Phacoemulsification; D011804:Quinolines / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D000077266:Moxifloxacin