Department of Ophthalmology, Nowshera Medical College, Nowshera-Pakistan.
J Ayub Med Coll Abbottabad. 2023 Feb-Mar;35(1):164-168. doi: 10.55519/JAMC-01-11011.
Intra-vitreal Vancomycin (IV-V) and ceftazidime (IV-C) are commonly in the treatment of acute post operative endophthalmitis. But there are suboptimal responses in some cases due to the emergence of antibiotic resistant micro-organisms. Moxifloxacin is a wide range antibacterial drug that is available as an eye drops for topical use for different types of ocular infections including post-operative endophthalmitis. But it has not been explored extensively as an intra-vitreal drug for post-operative endophthalmitis. We unveiled its broad spectrum anti-bacterial properties by giving it as an intra-vitreal route of delivery so to see its efficacy in post-operative endophthalmitis case. A 65 years old diabetic male presented with acute painful loss of vision in his right eye 2 days following his cataract extraction with posterior chamber intraocular lens implantation (PC IOL). His visual acuity (VA) on presentation was just counting finger close to eye. Slim lamp examination (SLE) revealed swollen lids, discharge in the inferior conjunctival fornix, conjunctival redness and chemosis, hazy cornea, fibrinous exudate in AC along with hypopyon, there was marked vitritis with yellowish fundal glow apparent. The patient was injected with intra-vitreal moxifloxacin 0.5mg/0.2 ml, along with topical and oral antibiotics in combination with steroids. VA reached to 6/24 and follow-up at 4th week didn't show any of intra ocular inflammatory changes on SLE. Intra-vitreal moxifloxacin mono-therapy is a better substitute to combination of vancomycin and ceftazidime due to its broad-spectrum coverage in acute post-operative endophthalmitis.
玻璃体内万古霉素（IV-V）和头孢他啶（IV-C）常用于治疗急性术后眼内炎。但由于抗生素耐药微生物的出现，一些情况下的治疗效果并不理想。莫西沙星是一种广谱抗菌药物，可作为滴眼液用于治疗不同类型的眼部感染，包括术后眼内炎。但它作为术后眼内炎的玻璃体内药物尚未得到广泛探索。我们通过玻璃体内给药的方式展示了它的广谱抗菌特性，以观察它在术后眼内炎病例中的疗效。一名 65 岁男性糖尿病患者，在白内障摘除联合后房型人工晶状体植入术后 2 天出现右眼急性疼痛性视力丧失。他就诊时的视力仅为眼前指数。眼压计检查显示眼睑肿胀，下穹窿结膜有分泌物，结膜充血和水肿，角膜混浊，前房有纤维蛋白性渗出物和前房积脓，玻璃体明显炎症，眼底可见黄白色反光。患者接受了玻璃体内莫西沙星 0.5mg/0.2ml 注射，同时联合局部和全身抗生素及类固醇治疗。视力恢复至 6/24，第 4 周随访时眼压计检查未见任何眼内炎症变化。在急性术后眼内炎中，与万古霉素和头孢他啶联合治疗相比，玻璃体内莫西沙星单一治疗具有更广泛的覆盖范围，是更好的替代方案。
