Intracameral moxifloxacin (Vigamox): in vitro safety on human ocular cells

Purpose The 4. generation fluorochinolon moxifloxacin covers most isolates causing endophthalmitis. It is safe and effective for systemic and topical use, however only very limited data is available on prophylactic intracameral administration to prevent endophthalmitis. This study investigates the safety of Viagamox (moxifloxacin) for intracameral application in a cell culture model Methods Endothelial toxicity of Vigamox (moxifloxacin) was evaluated in cultured human corneas. Toxic effects regarding primary human RPE, trabecular meshwork cells (TMC) and corneal endothelial cells (CEC) were evaluated after 24h and under conditions of oxidative stress. By treating cells with TNF-a, LPS and IL-6 the effects of moxifloxacin on viability under conditions of inflammation were investigated. Toxicity was evaluated by measuring the inhibition of cell proliferation (MTT). Cell viability was quantified by a microscopic live dead assay Results No corneal endothelial toxicity could be detected after 30 days treatment with 500µg/mL moxifloxacin. RPE,TMC,and CEC showed adverse effects on proliferation and viability at concentrations higher than 150µg/mL moxifloxacin only. Preincubation with TNF-a, LPS, IL-6 or H2O2 and subsequent treat with moxifloxacin concentrations up to 150µg/ml for 24h had no significant effect on proliferation and viability Conclusion Moxifloxacin concentrations up to 150µg/mL had no significant toxicity on RPE, TMC, CEC and human corneas. The MIC90 of moxifloxacin for common pathogens of endophthalmitis is known to be in the range of 0.25 - 2.5µg/mL. Therefore, intracameral use of moxifloxacin at concentrations up to 150µg/mL may be safe and effective to prevent endophthalmitis after intraocular surgery