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Moxifloxacin preferred injectable antibiotic in cataract surgery

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WAILEA, Hawaii — For ASCRS members polled in a 2017 clinical survey, moxifloxacin was the most preferred injectable intraoperative antibiotic for cataract surgery, David F. Chang, MD, said in a presentation at Hawaiian Eye 2018.

“The most recent survey shows that moxifloxacin is the most common and that vancomycin has dropped way down. It used to be the opposite; vancomycin was the most common,” Chang said in an update on intracameral antibiotic prophylaxis.

“People continue to use this through the Vigamox (moxifloxacin, Alcon/Novartis) preparation because it is unpreserved,” he said.

Citing a meta-analysis of 17 observational studies involving 925,000 eyes over two decades published last week in British Journal of Ophthalmology, Chang said pooled rates of endophthalmitis were reported at 0.033% with intracameral cefuroxime, 0.15% with moxifloxacin and 0.12% with vancomycin.

“In terms of safety, they talk about HORV [hemorrhagic occlusive retinal vasculitis]. Cefuroxime had minimal toxicity, but moxifloxacin was the most studied for safety and had a low toxicity profile for all concentrations,” Chang said.

A multicenter trial is being launched this month by the ASCRS Research Council to pool resources in a randomized controlled trial featuring moxifloxacin topical vs. intracameral topical with the aim of appealing to the National Eye Institute to study the prophylactic use of intracameral moxifloxacin vs topical moxifloxacin. Interested parties should contact researchcouncil@ascrs.org prior to Jan. 28. – by Patricia Nale, ELS

References:

Arshinoff S. J Cataract Refract Surg. 2016;doi:10.1016/j.jcrs.2016.10.017.

Chang DF. Routine IC antibiotic prophylaxis for cataract surgery. Presented at: Hawaiian Eye 2018; Jan. 13-19, 2018; Wailea, Hawaii.

Bowen RC, et al. Br J Ophthalmol. 2018; doi:10.1136/bjophthalmol-2017-311051.

Disclosure: Chang reports no relevant financial disclosures.