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Safety of Prophylactic Intracameral Moxifloxacin Injection after Uncomplicated Phacoemulsification Surgery

Purpose: Endophthalmitis is a serious inflammation that affect the eye and represents a major threat after cataract operation in the form of postoperative endophthalmitis (POE). With more than 10 million cataract operation performed yearly all over the world, effective POE prophylaxis is essential. Many postoperative prophylactic measures are available including Intracameral (IC), topical, subconjunctival and oral antibiotic preparations. Currently, although IC administration is widely accepted, there is no consensus on the best prophylactic therapy or route of administration for POE prevention. Objective: Determine the safety of prophylactic intracameral injection of moxifloxacin after uncomplicated phacoemulsification surgery. Patients and Methods: This prospective randomized study included 60 eyes of patients who had uncomplicated phacoemulsification cataract operation selected from Mansoura ophthalmic center, Mansoura University, Egypt, in the period from August 2017 to August 2018. After the surgery the cases were classified into two groups. The first group (30 eyes) received ordinary postoperative systemic and topical ocular treatment (Control group) and the second group (30 eyes) received ordinary postoperative systemic and topical ocular treatment in addition to injection with IC moxifloxacin at the end of operation. The cases were followed up at the following up at; first day,1 week, 1 month & 3 months after surgery Results: There was statistically significant difference in the BCVA, but there was no statistically significant difference in the central corneal thickness and endothelial cell count in the cases within the two groups 1 and 3 months of surgery. There was a statistically significant decrease in the central corneal thickness, endothelial cell count and number of cells in anterior chamber in the cases within the two groups along the follow up period after the surgery as compared with the preoperative value. Conclusion: The current study supported the safety of IC injection of undiluted moxifloxacin in a concentration of 0.5 mg /0.1 ml (vigamox) in terms of anterior chamber reaction, central corneal thickness, endothelial cell count and visual rehabilitation.