Safety of intracameral moxifloxacin prophylaxis in pediatric lens related surgeries
Author Disclosure Block: S. Khalili: None. A. Imtirat: None. S. Williams: None. A. Ali: None. N. Tehrani: None. K. Mireskandari: None.
Abstract Body:
Purpose: The general safety of intracameral (IC) moxifloxacin (Vigamox™) prophylaxis for endophthalmitis after cataract surgeries in adults has been shown in several studies. Herein, we aim to investigate the safety of IC moxifloxacin prophylaxis in pediatric lens related surgeries.
Study Design: Retrospective study
Methods: All consecutive patients undergoing lens related surgery between January 2014 and December 2016 were reviewed. Patients with pre-existing diagnosis of uveitis, glaucoma or other ocular comorbidity other than cataract were excluded. The intraocular pressure (IOP), central corneal thickness (CCT), endothelial cell density (ECD), corneal edema, anterior chamber (A/C) cell/flare activity, and best corrected visual acuity (BCVA) before and after surgery were collected.
Results: We included 181 eyes undergoing lens related surgeries in 122 patients. In 141 surgeries IC moxifloxacin was used (IC-Mox), while subconjunctival antibiotics were used in 40 eyes (Subconj-AB). The average age at the time of surgery was 59.3 and 82.2 months respectively in IC-Mox and Subconj-AB groups. The pre-operative CCT, ECD, and BCVA were not statistically different between groups (p=0.35, 0.34, and 0.8 respectively). The pre-op IOP was notably higher in group 2 (15.6 vs. 13.1mmHg; p=0.0005). Mean follow-up was 21 months in both groups. No post-operative complications such as endophthalmitis, retinal detachment, anterior uveitis or glaucoma were noted in either group. Comparison of post-operative IOP, CCT, ECD, corneal edema, A/C flare activity and BCVA was not statistically significant (p=0.07, 0.6, 0.07, 0.06, 0.3 and 0.7, respectively). The A/C cell activity at its highest value in the first 6 weeks after surgery was significantly higher in the Subconj-AB group compared to that of the IC-Mox group (p=0.007).
Conclusions: The use of IC Moxifloxacin prophylaxis in pediatric patients did not show any post-operative adverse event on IOP, CCT, ECD, corneal edema, A/C flare when compared to subconjunctival antibiotics. No adverse outcomes were recorded at 21 months follow up. We believe that IC moxifloxacin is safe in pediatric population.
