RESUMO
PURPOSE: The development of endophthalmitis after cataract surgery often results in significant vision loss. Inhibition of bacterial proliferation in the anterior chamber using antibiotic eye drops is important to prevent endophthalmitis after cataract surgery. We aimed to determine the sensitivity of fluoroquinolones against Enterococcus faecalis ocular isolates and the efficacy of fluoroquinolones to prevent E. faecalis-induced endophthalmitis in aphakic rabbits. METHODS: The minimum inhibitory concentrations (MICs) of moxifloxacin (MFLX) and levofloxacin (LVFX) used in ophthalmic solutions for 13 E. faecalis isolates obtained from the conjunctival sac or endophthalmitis cases were determined. Eye drops containing MFLX (0.5%), LVFX (0.5%), or saline were administered to aphakic rabbits with endophthalmitis induced by E. faecalis. The eye drops were administered immediately after lensectomy and at 3 and 6 h after cataract surgery (early instillation group) or immediately after lensectomy and at 12 and 15 h after cataract surgery (delayed instillation group). Bacterial growth, electroretinography (ERG), and slit-lamp examination (SLE) were determined throughout the course of infection. RESULTS: In vitro susceptibility testing revealed that the MICs of MFLX for E. faecalis isolates were lower than those of LVFX. In the early ocular instillation groups, MFLX significantly improved SLE scores, ERG, and viable bacterial counts compared with LVFX and saline (all, P<0.05). There were no significant differences in any parameter between MFLX and saline in the delayed ocular instillation groups. CONCLUSIONS: Early ocular instillation of MFLX delays retinal damage compared with LVFX when used to treat E. faecalis-induced endophthalmitis after cataract surgery.
Assuntos
Compostos Aza/farmacologia , Endoftalmite/prevenção & controle , Infecções por Bactérias Gram-Positivas/prevenção & controle , Levofloxacino , Ofloxacino/farmacologia , Quinolinas/farmacologia , Administração Oftálmica , Animais , Antibacterianos/farmacologia , Afacia Pós-Catarata/microbiologia , Modelos Animais de Doenças , Eletrorretinografia , Endoftalmite/microbiologia , Enterococcus faecalis/isolamento & purificação , Infecções Oculares Bacterianas/microbiologia , Infecções Oculares Bacterianas/prevenção & controle , Fluoroquinolonas , Infecções por Bactérias Gram-Positivas/microbiologia , Testes de Sensibilidade Microbiana , Moxifloxacina , Soluções Oftálmicas , Facoemulsificação/efeitos adversos , Coelhos , Fatores de TempoRESUMO
Of 857 cultures of material collected from the eyelids, conjunctivae, and contact lenses of 51 extended-wear soft-contact-lens wearers, 44 (5%) grew potential pathogens. The aphakic patients wearing contact lenses had fewer recoverable pathogens (24 of 295 or 8%) than a group of preoperative cataract patients (63 of 295 or 21%). On five occasions, positive cultures accompanied clinical symptoms, and on three occasions, repeated cultures grew the same potential pathogen.
