Employing the Intraocular Irrigating Solution Containing Moxifloxacin in Cases of Posterior Capsular Rupture

Abstract

Introduction: Although the high risk of postoperative endophthalmitis in cases of posterior capsular rupture (PCR) has been well-known, no specific prophylaxis has been proposed. In recent years, the safety of intracameral moxifloxacin (MFLX) has been established. Therefore, we have been performing cataract surgery in cases of PCR using an irrigating solution containing MFLX. Methods: We retrospectively examined the clinical records of nine patients (nine eyes) who suffered PCR during cataract surgery between 2012 and 2014. Once PCR was confirmed, surgery was continued using an irrigating solution containing MFLX (100-fold dilution: 50µg/ml). We investigated the ocular parameters at 3–12 months postoperatively (6.2 ± 2.4 months). Results: After surgery, the intraocular pressure was 15.3 ± 2.3 mmHg, the endothelial cell density was 2702 ± 336/mm2, the retinal thickness was 238 ± 12 µm and the corrected visual acuity was 20/25 or greater in all patients. None of the patients developed endophthalmitis or complications related to MFLX administration such as cystoid macular edema (CME) or toxic anterior segment syndrome. Conclusions: In the present study, no apparent adverse effect of MFLX containing irrigating solution was indicated. Because the minimum inhibitory concentration of MFLX for 90% of bacteria is low and there have been no reports of its retinal toxicity, we believe that the MFLX-containing irrigating solution is a rational choice for treating vitreous contamination following PCR.