1. [Intracameral moxifloxacin: a safe option for endophthalmitis prophylaxis? In vitro safety profile for intraocular application].
- Author
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Kernt M, Hirneiss C, Neubauer AS, Liegl RG, Eibl KH, Wolf A, de Kaspar H, Ulbig MW, and Kampik A
- Subjects
- Anterior Chamber, Cell Count, Cell Survival drug effects, Cells, Cultured, Dose-Response Relationship, Drug, Endophthalmitis immunology, Endothelial Cells immunology, Epithelium, Corneal immunology, Fluoroquinolones, Humans, In Vitro Techniques, Inflammation Mediators metabolism, Lens, Crystalline immunology, Lipopolysaccharides immunology, Moxifloxacin, Oxidative Stress drug effects, Oxidative Stress immunology, Pigment Epithelium of Eye immunology, Trabecular Meshwork immunology, Anti-Infective Agents administration & dosage, Anti-Infective Agents toxicity, Aza Compounds administration & dosage, Aza Compounds toxicity, Endophthalmitis prevention & control, Endothelial Cells drug effects, Epithelium, Corneal drug effects, Lens, Crystalline drug effects, Pigment Epithelium of Eye drug effects, Quinolines administration & dosage, Quinolines toxicity, Trabecular Meshwork drug effects
- Abstract
Background: Moxifloxacin (Vigamox), a 4th-generation fluoroquinolone, covers most isolates causing endophthalmitis. It is safe and effective for systemic and topical use; however, only very limited data are available on prophylactic intracameral administration to prevent endophthalmitis. This study investigated the safety of Vigamox for intracameral application in a cell-culture model., Methods: The endothelial toxicity of moxifloxacin (Vigamox) was evaluated in cultured human corneas. Primary human retinal pigment epithelium cells (RPEs), trabecular meshwork cells (TMCs), lens epithelium cells (LECs), and corneal endothelial cells (CECs) were treated with concentrations of Vigamox. Toxic effects were evaluated after 24 h (MTT assay and live-dead assay). By treating TMC, CEC, and RPE cells either with oxidative stress or tumor necrosis factor-alpha (TNF-a), lipopolysaccharide (LPS), and interleukin-6 (IL-6), the effects of moxifloxacin on cellular viability under conditions of inflammation were investigated., Results: No corneal endothelial toxicity could be detected after 30 days of treatment with moxifloxacin 500 microg/ml. Primary RPEs, TMCs, LECs, and CECs showed adverse effects on proliferation and viability only at concentrations higher than 150 microg/ml moxifloxacin. After preincubation with TNF-a, LPS, and IL-6 for 24 h and subsequent treatment with moxifloxacin at concentrations of 10-150 microg/ml for 24 h, no significant decrease in proliferation or viability was observed. H2O2 exposure did not increase cellular toxicity, Conclusion: Vigamox did not show significant toxicity on primary RPEs, TMCs, LECs, CECs, or human corneal endothelium at concentrations up to 150 microg/ml. The MIC90 of moxifloxacin for pathogens commonly encountered in endophthalmitis is known to be in the range of 0.25-2.5 microg/ml. Therefore, intracameral use of Vigamox at concentrations up to 150 microg/ml may be safe and effective for preventing endophthalmitis after intraocular surgery.
- Published
- 2010
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