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Published on: September 27, 2021
Evaluation of moxifloxacin penetration into corneal lenticules extracted during SMILE surgery
Mehmet Altun1, Mevlut Celal Ocal1, Husna Topcu2
1Department of Ophthalmology, Aritmi Osmangazi Hospital, Bursa, Turkey.
Purpose:
To evaluate the penetration of topically applied moxifloxacin 0.5% in corneal lenticule tissue collected from healthy patients undergoing the Kerato Lenticule Extraction (KLEx) surgery.
Methods:
Thirty-seven eyes of 37 patients received a single drop of moxifloxacin 0.5% before corneal lenticule tissue collection in KLEx surgery. The lenticule samples were divided into three groups according to collection time. Eight lenticules (21.6%) were included in group 1 (0.5 to 1.0 h), 19 lenticules (51.3%) in group 2 (1.0 to 1.5 h), and 10 lenticules (27.0%) in group 3 (1.5 to 2.0 h). The lenticules were stored at -80 °C until analysis. Moxifloxacin concentration in the lenticule tissue was measured using a validated liquid chromatography mass spectrometry (LC-MS/MS) technique.
Results:
The mean corneal lenticule concentration of moxifloxacin was 22.54 ± 13.63 μg/g in group 1, 17.8 ± 10.88 μg/g in group 2, and 9.88 ± 4.2 μg/g in group 3. These concentrations were higher than the minimum inhibitory concentration (MIC) values of bacterial isolates, except Pseudomonas aeruginosa.
Conclusion:
This study demonstrates that a single preoperative drop of moxifloxacin 0.5% achieves corneal tissue concentrations above the MIC for most bacterial pathogens except Pseudomonas aeruginosa. These results suggest that such prophylactic administration may effectively reduce the risk of post-operative infection in patients undergoing KLEx surgery.
Insights
A single preoperative drop of moxifloxacin 0.5% achieves effective corneal tissue concentrations for Kerato Lenticule Extraction (KLEx) surgery, potentially reducing infection risk. However, concentrations were insufficient against Pseudomonas aeruginosa.
Area of Science:
- Ophthalmology
- Pharmacology
- Microbiology
Background:
- Corneal lenticule extraction (KLEx) is a refractive surgery procedure.
- Post-operative infections are a risk following ocular surgery.
- Moxifloxacin is a fluoroquinolone antibiotic used to prevent bacterial infections.
Purpose of the Study:
- To assess the penetration of topical moxifloxacin 0.5% into corneal lenticule tissue.
- To determine if moxifloxacin concentrations in corneal tissue exceed the minimum inhibitory concentration (MIC) for common bacterial pathogens.
Main Methods:
- A single drop of moxifloxacin 0.5% was administered to 37 patients prior to KLEx surgery.
- Corneal lenticules were collected at different time intervals (0.5-2.0 hours) post-administration.
- Moxifloxacin concentrations were quantified using liquid chromatography-mass spectrometry (LC-MS/MS).
Main Results:
- Mean moxifloxacin concentrations in corneal lenticules ranged from 9.88 ± 4.2 μg/g to 22.54 ± 13.63 μg/g.
- These concentrations were above the MIC for most tested bacterial isolates.
- Concentrations were lower in samples collected later, indicating a time-dependent decrease.
Conclusions:
- Preoperative topical moxifloxacin 0.5% achieves therapeutic concentrations in corneal tissue for KLEx surgery.
- This prophylactic approach may lower the incidence of post-operative ocular infections.
- Moxifloxacin efficacy may be limited against Pseudomonas aeruginosa infections.
