Moxifloxacin intrakameral: Eine sichere Option zur Endophthalmitisprophylaxe?

Background: Moxifloxacin (Vigamox®), a 4th-generation fluoroquinolone, covers most isolates causing endophthalmitis. It is safe ande 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 μg/ml. Primary RPEs, TMCs, LECs, and CECs showed adverse effects on proliferation and viability only at concentrations higher than 150 μg/ml moxifloxacin. After preincubation with TNF-a, LPS, and IL-6 for 24 h and subsequent treatment with moxifloxacin at concentrations of 10-150 μg/ml for 24 h, no significant decrease in proliferation or viability was observed. H₂O₂ exposure did not increase cellular toxicityConclusion: Vigamox® did not show significant toxicity on primary RPEs, TMCs, LECs, CECs, or human corneal endothelium at concentrations up to 150 μg/ml. The MIC90 of moxifloxacin for pathogens commonly encountered in endophthalmitis is known to be in the range of 0.25-2.5 μg/ml. Therefore, intracameral use of Vigamox® at concentrations up to 150 μg/ml may be safe and effective for preventing endophthalmitis after intraocular surgery.