Incremental effect of topical and oral moxifloxacin administration with surgical intracameral prophylaxis

Lukewich, Mark K.; Modabber, Milad; Hu, Albert; Arshinoff, Steve A.

doi:10.1016/j.jcjo.2020.12.020

Cited by 2 publications

(1 citation statement)

References 61 publications

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“…Though our patient received IC moxifloxacin at the end of surgery (500 µg in 0.1 mL), the quantity delivered and the antibiotic concentration achieved was likely insufficient to prevent POE due to a moxifloxacin-resistant strain of CoNS [10][11][12]. Administration of 0.1 mL is difficult and inaccurate [13].…”

Section: Discussionmentioning

confidence: 99%

Bilateral Endophthalmitis After Immediately Sequential Bilateral Cataract Surgery (ISBCS) in an Immunodeficient Patient

Qi¹,

Hébert²,

Chen³

et al. 2022

Act Sci Oph

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Introduction: Bilateral simultaneous postoperative endophthalmitis (BSPOE) is a rare but potentially devastating complication following immediately sequential bilateral cataract surgery (ISBCS). We present a case of BSPOE in an immunocompromised patient to suggest actionable precautions in this patient population.Patient and clinical findings: A 79-year-old male with specific pneumococcal antibody deficiency underwent uneventful ISBCS with prophylactic intracameral 0.1 mL undiluted moxifloxacin 0.5%. The patient returned with decreased visual acuities of light perception in the right eye (OD) at 5 days and count fingers in the left eye (OS) at 7 days postoperatively with severe anterior chamber inflammation in each eye. Diagnosis, Intervention, and Outcomes:The patient was diagnosed with BSPOE. Tap-and-inject was performed emergently on day 5 OD and day 7 OS with intravitreal vancomycin 1 mg/0.1 mL, dexamethasone 0.4 mg/0.1 mL, and ceftazidime 2.25 mg/0.1 mL.Cultures done OD were positive for methicillin-resistant coagulase-negative Staphylococcus epidermidis. The patient later underwent an anterior chamber washout, pars plana vitrectomy, and intravitreal injections of vancomycin 1 mg/0.1 mL and dexamethasone 0.04 mg/0.1 mL in both eyes (OU) and recovered 20/20 visual acuity OU at 6 weeks postoperatively. Conclusions:This case raises critical issues about the adequacy of intracameral prophylaxis methods for immunosuppressed patients.

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Section: Discussionmentioning

confidence: 99%