Can intraocular lenses deliver antibiotics intracamerally?

To determine the therapeutic concentrations of moxifloxacin achieved in an artificial anterior chamber by soaking the hydrophobic acrylic AcrySof™ SA60 (Alcon Inc.) intraocular lens (IOL) and the hydrophilic collamer Afinity™ CQ2015 (Staar Inc.) IOL in commercially available moxifloxacin 0.5% (Vigamox™; Alcon Inc.).

Forty IOLs (20 Acrysof SA60 and 20 Afinity CQ2015) were soaked in 1 mL of commercially available moxifloxacin 0.5%: 10 of each IOL for 1 min, and another 10 of each IOL for 10 min. The IOLs were placed on absorbent pads for 10 s on each side to dry excess liquid, and then placed in vials of 10 mL balanced salt solution (BSS™) for 30 min. Five milliliters of the balanced salt solution was removed and analyzed by high-pressure liquid chromatography to determine antibiotic levels.

The moxifloxacin levels achieved after soaking the hydrophobic SA60 lens were 0.238 and 0.342 μg/mL for 1 and 10-min soaks, respectively. The moxifloxacin levels achieved after soaking the hydrophilic CQ2015 lens were 0.283 and 0.717 μg/mL for 1 and 10-min soaks, respectively.

Both lenses were capable of delivering clinically significant antibiotic levels after a 1-min soak. Moxifloxacin concentrations reached at both 1 and 10-min soak times exceed the MIC(90) of the most common pathogens responsible for postoperative endophthalmitis. The antibiotic-soaked IOL has potential to become a clinically significant technique in the prevention of postoperative endophthalmitis.