Abstract
BackgroundAntimicrobials may be injected into silicone oil-filled eyes with endophthalmitis, but the interaction with oil is unclear. The purpose of the experiment is to determine whether vancomycin, amikacin, and amphotericin B mix with silicone oil.MethodsUsing the relative proportions of the human eye, 4 ml of 1000 centistokes silicone oil was centrifuged with 0.1 ml of vancomycin 1 mg/0.1 ml, amikacin 0.4 mg/0.1 ml, or amphotericin B 5 µg/0.1 ml in vitro and eluted. The aqueous was immediately analyzed with a liquid chromatographer/mass spectrometer and after 24 h.ResultsWithin 24 h, a mean of 26.9 μmol/L of vancomycin, 0 nmol/L of amikacin, and 0 nmol/L of amphotericin B were recovered. When the concentrations of amikacin and amphotericin B were increased 100-fold, 0 nmol/L of amikacin and 75.7 µmol/L of amphotericin B were recovered.ConclusionsVancomycin and amphotericin B partially mixed with the silicone oil. Amikacin was not recovered from the antibiotic–silicone oil mixture.
Highlights
Antimicrobials may be injected into silicone oil-filled eyes with endophthalmitis, but the interaction with oil is unclear
Vancomycin and amphotericin B partially mixed with the silicone oil
Amikacin was not recovered from the antibiotic–silicone oil mixture
Summary
Antimicrobials may be injected into silicone oil-filled eyes with endophthalmitis, but the interaction with oil is unclear. The purpose of the experiment is to determine whether vancomycin, amikacin, and amphotericin B mix with silicone oil. Intravitreal injections are effective, patients with severe infections or concurrent retinal detachments may benefit from pars plana vitrectomy (PPVs) with silicone oil (SO) tamponades to decrease the bacterial or fungal load, remove inflammatory mediators, and reattach the retina [1]. Published studies have reported better visual and anatomic outcomes with PPVs and silicone oil compared to core vitrectomies alone in patients with endophthalmitis. Silicone oil has been reported to decrease bacterial and fungal survival in vitro. The oil was effective in decreasing the microbial loads of Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Escherichia coli, Fusobacterium spp., Clostridium tertium, Peptotstreptococcus spp., Bacteroides fragilis, Candida albicans, and Aspergillus spp. It is theorized that the viscous oil acts as a physical barrier to deprive the bacteria and fungus of nutrition, and the catalysts and components of the oil may be toxic to the microbes; the growth of certain anaerobic bacteria like Propionibacterium acnes and yeast like Candida albicans may not be fully inhibited by the oil [2, 3]
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