Abstract

SO.20.08

Intracameral Moxifloxacin: A save option to prevent endophthalmitis? – in vitro safety-profile of Vigamox® for intraocular application

Raffael Liegl, Christoph  Hirneiss, Aljoscha S. Neubauer, Kirsten H. Eibl, Armin Wolf, Herminia de Kaspar, Michael W. Ulbig, Anselm Kampik, Marcus Kernt
Augenklinik der Ludwig-Maximilians-Universität München, München

Objective
Moxifloxacin (Vigamox®), a fourth generation fluorochinolon, covers most isolates causing endophthalmitis. It is safe and effective for systemic and topical use, however only very limited data is available on prophylactic intracameral administration to prevent endophthalmitis. This study investigates the safety of Vigamox® for intracameral application in a cell culture model.
Methods
Endothelial toxicity of moxifloxacin (Vigamox®) was evaluated in cultured human corneas. Primary human RPE, trabecular meshwork cells (TMC), lensepithelium cells (LEC) and corneal endothelial cells (CEC) were treated with concentrations of Vigamox®. Toxic effects were evaluated after 24 hours (MTT-assay and Live-Dead-Assay). By treating TMC, CEC and RPE cells with either with oxidative stress or TNF-a, LPS and 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 treatment with 500µg/mL of moxifloxacin. Primary RPE, TMC, LEC and CEC showed adverse effects on proliferation and viability at concentrations higher than 150µg/mL moxifloxacin only. After preincubation with TNF-a, LPS, and IL-6 for 24 hours and subsequent treat with moxifloxacin at concentrations from 10µg/ml to 150µg/ml for 24 hours no significant decrease in proliferation and viability was observed. H2O2 exposure did not increase cellular toxicity.
Conclusions
Vigamox® did not show significant toxicity on primary RPE, TMC, LEC, CEC and human corneal endothelium for concentrations up to 150µg/mL. The MIC90 of moxifloxacin for pathogens commonly encountered in endophthalmitis is known to be in the range of 0.25µg/ml to 2.5µg/ml. Therefore, intracameral use of Vigamox® at concentrations up to 150µg/mL of moxifloxacin may be safe and effective to prevent endophthalmitis after intraocular surgery.

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