Abstract
Quinolone antibacterial activity is related to its chemical structure, a synthetic fluorinated analog of nalidixic acid. Cataract surgery is responsible for visual improvement having a major positive impact on the quality of patients� lives. According to the international guidelines, the administration of levofloxacin after cataract surgery decreases the incidence of postoperatively endophthalmitis. In this context we aimed to study the impact of adding topical fluoroquinolones to the conventional treatment after cataract surgery on the ocular surface and tear film. 125 of eyes of 125 patients with cataract were included. The enrolled patients were divided into three groups, a control group of patients that received topical Tobramycin, Dexamethasone and Indomethacin, a second group where moxifloxacin was added and a third group with levofloxacin instead of moxifloxacin. For all the patients, tear film breakup time, Schirmer II test, slit lamp examination preoperatively and postoperatively at one week were performed together with individual Ocular Surface Disease Index at one week after cataract surgery. The test results revealed that 52% of our studied patients had an abnormal preoperatively tear film breakup time, and 76.8% after cataract surgery, with a statistically significant decrease of the measured values. The preoperatively measured quantity of tears presented a no statistically significant decrease one week after cataract surgery. Also, we found an increase in the percentage of patients with punctate epithelial erosions. It is important and useful to identify prior to surgery patients with ocular surface disease and the ones at risk to develop clinical manifestations in order to treat them accordingly because, cataract surgery exacerbates the preexistent ocular symptoms. The addition of topical fluoroquinolones after cataract surgery in patients with dry eye is safe, with minimal alterations of the ocular surface and tear production, without statistically significant differences as compared to the control group.
Highlights
Cataract surgery is one of the most common ocular surgical procedure performed mainly on the aging population[1]
The moxifloxacin group, consisting of 36 patients were moxifloxacin 1 drop 4 times-a-day was added to the previous treatment and the levofloxacin group made of 52 patients, were moxifloxacin was replaced by levofloxacin 1 drop 4 times-a-day
If we focus our attention on the slit lamp examination of the ocular surface, we can observe that the incidence of corneal punctate epithelial erosions (PEE) has increased significantly (p
Summary
Cataract surgery is one of the most common ocular surgical procedure performed mainly on the aging population[1]. The number of cataract extractions is constantly growing, due to different factors such as increasing of life expectancy, lifestyle, patient mentality and easier access to the latest surgical techniques that allow fast recovery with excellent results. Cataract surgery is considered an ambulatory routine procedure, potential serious complications resulting in permanent visual impairment can occur. The development of postoperatively endophthalmitis as a result of an intraocular infection is well-known [2]. Preoperative periocular skin disinfection with topical povidone iodine is widely adopted and is considered one of the basic procedures in the prevention of infectious postoperative endophthalmitis[4]. Based on the recent prospective studies, it seems that the administration of intracameral antibiotic at the end of cataract surgery is an effective
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