Determination of aqueous and vitreous concentration of moxifloxacin 0.5% after delivery via a dissolvable corneal collagen shield device
Accepted 27 April 2005.
Purpose
To determine the penetration of moxifloxacin 0.5% in the human aqueous and vitreous when delivered by a presoaked collagen shield.
Setting
University-based clinical practice.
Methods
Moxifloxacin 0.5% was administered before vitrectomy surgery in 10 patients using a 24-hour dissolvable cross-linked corneal collagen shield delivery device. Aqueous and vitreous samples were obtained after the shield was placed for 4 hours in the first 5 patients and for 24 hours in the second 5 patients. Assays were performed using high-performance liquid chromatography.
Results
Delivery of moxifloxacin via a collagen shield revealed a mean aqueous concentration of 0.30 μg/mL ± 0.17 (SD) 4 hours after placement (n = 5). Vitreous levels at 4 hours and aqueous and vitreous levels at 24 hours were negligible using this route of administration. Peak aqueous moxifloxacin levels occurred soon after shield placement. This is when high concentrations of moxifloxacin are most needed to clear the aqueous of bacteria. The minimum inhibitory concentration at which 90% of the isolates were inhibited for organisms commonly responsible for endophthalmitis was exceeded in the 4-hour aqueous group. Negligible concentrations were detected at 24 hours.
Conclusions
Although aqueous moxifloxacin levels achieved through the use of a collagen shield delivery device are lower than via topical drops, there are several advantages to this route of delivery that make it appealing in the immediate postoperative period. Future studies will be needed to define precisely the role of fourth-generation fluoroquinolones and presoaked collagen shields in the prophylaxis or management of intraocular infections.
From the Department of Ophthalmology and Visual Science (Hariprasad), University of Chicago, Chicago, Illinois, Barnes Retina Institute and the Department of Ophthalmology and Visual Science (Shah), Washington University School of Medicine, St. Louis, Missouri, and College of Pharmacy (Chi, Prince), University of Houston, Houston, Texas, USA
Reprint requests to Seenu M. Hariprasad, MD, 15651 Ferncreek Drive, Chesterfield, Missouri, 63017-0701, USA.
Presented in part at the 140th Annual Meeting of the American Ophthalmological Society, Hot Springs, Virginia, May 2004.
Supported by the Retina Research and Development Foundation, St. Louis, Missouri, USA.
No author has a financial or proprietary interest in any material or method mentioned.
ABSTRACT