Efficacy and Safety of Intracameral Moxoft Eye Drops (Moxifloxacin Ophthalmic Solution 0.5%) for Endophthalmitis Prophylaxis in Cataract Surgery.

Objective: To evaluate the efficacy and safety of intracameral Moxoft eye drops (Moxifloxacin ophthalmic solution 0.5%) administered at the conclusion of phacoemulsification cataract surgery for the purpose of endophthalmitis prophylaxis. Design: Open label, multicentre, prospective. Setting: Three ophthalmologists across India. Methods: A total of 134 outpatients of either sex undergoing phacoemulsification with no ocular pathology other than cataract and meeting all inclusion/exclusion criteria were enrolled in the study. All patients received preoperatively 1 drop of Moxoft eye drops (Moxifloxacin ophthalmic solution 0.5%) topically every 15 minutes atleast 4 times one hour prior to surgery. 0.1 ml moxifloxacin solution was aspirated into the tuberculin syringe and injected into the capsular bag under the capsulorhexis edge after completion of the Phacoemulsification and IOL implantation. Post-operative treatment was as per standard protocol. Patients were assessed pre-operatively and on day 1, day 7 & day 30 after surgery for ocular symptom scores for pain in eyes, ocular discharge, hazy cornea, conjunctival hyperemia, and hypopyon and chemosis. Anterior chamber (AC) reaction was graded (if present) on all the visits with fixed slit-lamp settings and on 5-point rating scale for AC flare and cells in AC. Global assessment was done for efficacy and tolerability at the end of therapy on a 3-point scale. Result: Thirteen patients were excluded from the analysis due to insufficient data and an intentionto- treat analysis was done for efficacy on 121 patients. There was significant reduction in scores of pain in eyes, conjunctival hyperemia, mean AC flare, mean AC cells (p<0.0001 for all) and ocular discharge (p=0.018). Hypopyon and/or corneal endothelial cell damage was observed in none of the patients. Therapy was rated good to excellent on efficacy and tolerability parameters with no reporting of a poor rating. Conclusion: Moxoft eye drops (Moxifloxacin ophthalmic solution 0.5%) is safe for use by intracameral administration with no corneal decompensation. Tolerability and post-operative results were found to be excellent.