Safety of besifloxacin ophthalmic suspension 0.6% in cataract surgery patients

Abstract

The refractive outcome after cataract surgery depends on several factors. According to Norrby, 1 the sources of error in the refractive outcome after cataract surgery include postoperative anterior chamber depth (ACD), 35.47%; postoperative refraction, 26.98%; axial length of the eye, 17.03%; corneal curvatures, asphericity, thickness, and refractive index, 10.19%; pupil size, 8.11%; refractive index of the intraocular lens (IOL), 1.19%; vitreous refractive indices, 0.54%; aqueous refractive index, 0.36%; retinal thickness, 0.14%; and eye chart distance, 0.01%.Per the above, the postoperative refraction, second to only postoperative ACD, is crucial in determining the error from the preoperative intended refractive target. 1,2 Since the corrected distance visual acuity (CDVA) is the endpoint of manifest refraction, we investigated whether the CDVA after cataract surgery affects the assessment of refractive outcome.Two hundred ninety-five patients had uneventful phacoemulsification with implantation of a posterior chamber IOL. The same surgeon (S.L.) performed all procedures through a 2.4 mm temporal limbal incision and implanted a 3-piece IOL with an acrylic optic and poly(methyl methacrylate) haptics (iSert, Hoya Corp.) in all cases.Preoperatively, the biometry was obtained with optical low coherence reflectometry (Lenstar 900, Haag-Streit AG). The IOL power was calculated with the Holladay 2 formula. 3 Eyes with corneal pathology or previous corneal surgery were excluded. Postoperatively, the CDVA was obtained with manifest refraction 3 weeks after surgery or later. There were no postoperative complications. Eyes with a CDVA worse than 20/40 were excluded.One eye from each patient was included in the study. The eyes were divided into 2 groups, 1 with a postoperative CDVA of 20/20 or better and the other, of 20/25 to 20/40. For each group, the mean error and the mean absolute error (MAE) from the intended refractive target were calculated. The statistical comparison was performed with the Student t test. Significant difference was defined as a P value less than 0.05. cause manifest refraction can be refined more easily in eyes with better visual acuity potential. More refined manifest refraction should lead to more accurate assessment of the error from the intended refractive target.With modern IOL power formulas, the mean error and the MAE are used for adjusting the lens constant of the IOL in calculating the IOL power. 2 By continually adjusting the lens constant, the surgeon can improve the refractive accuracy in future cases. The present study indicates that one should be able to obtain more accurate assessment of the refractive outcome by using the postoperative manifest refraction from eyes with a CDVA of 20/20 or better. REFERENCES1. Norrby S. Sources of error in intraocular lens power calculation.

Safety of besifloxacin ophthalmic suspension 0.6% in refractive surgery: a retrospective chart review of post-LASIK patients

“…The results of this retrospective chart review are consistent with a previous retrospective chart review of routine cataract surgery cases where prophylactic besifloxacin or moxifloxacin was prescribed,41 as well a recent prospective, parallel-group, investigator-masked study of besifloxacin ophthalmic suspension 0.6% and moxifloxacin ophthalmic solution 0.5% in cataract patients 42. Parekh et al41 evaluated the safety of besifloxacin ophthalmic suspension in the cataract surgery setting through a retrospective chart review of routine cases (phacoemulsification with posterior chamber intraocular lens implantation), where besifloxacin ophthalmic suspension 0.6% or moxifloxacin ophthalmic solution 0.5% was prescribed.…”

“…Indeed, there were no reports of ADRs in either treatment group, and surgical outcomes were similar, as was the case in our analysis. Consistent with our study, daily dosing frequency was higher in the moxifloxacin group compared to the besifloxacin group ( P < 0.0001) 41. Malhotra et al42 studied corneal integrity in the eyes of 60 patients undergoing cataract extraction with intraocular lens (IOL) implantation.…”

“…Parekh et al41 evaluated the safety of besifloxacin ophthalmic suspension in the cataract surgery setting through a retrospective chart review of routine cases (phacoemulsification with posterior chamber intraocular lens implantation), where besifloxacin ophthalmic suspension 0.6% or moxifloxacin ophthalmic solution 0.5% was prescribed. As in our study, surgeons provided retrospective case information on surgical outcomes from consecutive cases and logged any adverse events related to the antibacterial used.…”

Besifloxacin Ophthalmic Suspension 0.6% in the Treatment of Bacterial Keratitis: A Retrospective Safety Surveillance Study

“…A retrospective chart review of LASIK surgery cases where besifloxacin ophthalmic 34 In cases where besifloxacin was used intraoperatively (31.8%), besifloxacin was instilled either before flap creation and/or after flap replacement. Similarly, 2 chart reviews of routine cataract surgery cases-a retrospective review 35 and a prospective review (Majmudar PA and Comstock TL, data presented at the 2013 meeting of the American Society of Cataract and Refractive Surgery)including a combined total of 826 eyes treated with besi-floxacin, found that the prophylactic use of besifloxacin ophthalmic suspension 0.6% was not associated with any significant safety concerns. Mean duration of besifloxacin treatment was 12.0 days in the retrospective study and 14.7 days in the prospective study, and most patients (58.8% and 70.5%) were administered besifloxacin thrice daily.…”

Safety of Besifloxacin Ophthalmic Suspension 0.6% in Cataract and LASIK Surgery Patients

“…The findings of these studies are consistent with those of previous retrospective and prospective safety studies of besifloxacin and moxifloxacin in the ophthalmic surgery setting (cataract surgery and LASIK). 17 – 19 …”