Objective This study was conducted to understand the effects of intracameral moxifloxacin in decreasing the incidence of postoperative endophthalmitis after cataract surgery in an eye hospital with a high volume surgical load. Methods and analysis In this single-centre, retrospective, clinical registry-based study, we compared the rates of postoperative endophthalmitis in 31 340 cataract surgery patients operated during 22 months after June 2018 who received intracameral moxifloxacin to 80 643 patients operated during 41 months before June 2018 who did not receive intracameral moxifloxacin. All patients received subconjunctival gentamycin and dexamethasone. Combined surgical procedures were excluded from the study. Results There was a significant reduction (p<0.001) of postoperative endophthalmitis rates in cataract surgeries from 0.144% (116/80 643) to 0.025% (8/31 340) after initiation of intracameral moxifloxacin. Endophthalmitis rates decreased from 0.120% (12/9942) to 0.009% (1/10 787) in phacoemulsification group and from 0.147% (104/70 701) to 0.034% (7/20 553) in manual small-incision cataract surgeries. Gram-positive organisms including Coagulase-negative staphylococci (37.9%, n=11) and Staphylococcus aureus ( S. aureus 34.5%, n=10) were the most common organisms isolated out of 29 culture-positive cases. 24.1% (28/116) endophthalmitis cases in group without moxifloxacin were culture positive compared with 14.3% (1/7) of cases in moxifloxacin group. 72% (n=8) of the Coagulase-negative staphylococci and 80% of S . aureus isolates (n=8) showed in vitro sensitivity to moxifloxacin. Conclusion Prophylactic use of intracameral moxifloxacin injection in addition to subconjunctival gentamycin in cataract surgery is associated with a significant decrease in rates of postoperative endophthalmitis when compared with the use of subconjunctival gentamycin alone in high volume settings. All data are available upon request.

中文翻译：

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在大容量手术环境中使用或不使用前房内莫西沙星预防的术后眼内炎

目的 本研究旨在了解在一家手术量大的眼科医院，前房注射莫西沙星对降低白内障术后眼内炎发生率的作用。方2018 年 6 月未接受前房内莫西沙星治疗的患者。所有患者均接受结膜下庆大霉素和地塞米松治疗。联合外科手术被排除在研究之外。结果 白内障手术的术后眼内炎发生率从 0 显着降低（p<0.001）。前房内莫西沙星开始后 144% (116/80 643) 至 0.025% (8/31 340)。超声乳化组的眼内炎发生率从 0.120% (12/9942) 降低到 0.009% (1/10 787)，而手动小切口白内障手术的眼内炎发生率从 0.147% (104/70 701) 降低到 0.034% (7/20 553)。革兰氏阳性菌包括凝固酶阴性葡萄球菌（37.9%，n=11）和金黄色葡萄球菌（S. aureus 34.5%，n=10）是从 29 例培养阳性病例中分离出的最常见的微生物。未使用莫西沙星组24.1%（28/116）的眼内炎病例培养阳性，而莫西沙星组为14.3%（1/7）。72% (n=8) 的凝固酶阴性葡萄球菌和 80% 的葡萄球菌。金黄色葡萄球菌分离株（n=8）对莫西沙星表现出体外敏感性。结论 与在大容量环境中单独使用结膜下庆大霉素相比，白内障手术中除结膜下庆大霉素外预防性使用前房内注射莫西沙星与术后眼内炎发生率显着降低相关。所有数据均可应要求提供。