Prevention of endophthalmitis by collagen shields presoaked in fourth-generation fluoroquinolones versus by topical prophylaxis.

Purpose: To compare the prophylaxis of collagen shields presoaked in antibiotics versus antibiotic drops after bacterial anterior chamber challenge.

Setting: John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA.

Methods: Forty rabbits received bilateral 0.03 mL intracameral injections of Staphylococcus epidermidis (5 x 10(8) colony-forming units). Four groups of 10 rabbits had their eyes randomized to receive (1) 3 mg/mL gatifloxacin (Zymar) drops or shield in Zymar, (2) Zymar drops or shield in 10 mg/mL gatifloxacin (Tequin), (3) 5 mg/mL moxifloxacin (Vigamox) drops or shield in Vigamox, or (4) balanced salt solution (BSS) drops or shield in BSS. Each eye received Zymar, Vigamox, or BSS 4 times 1 hour before injection. The antibiotic-BSS was administered every 2 hours (5 doses total). One day later, signs of endophthalmitis were scored under the slitlamp.

Results: Groups 1 and 2 had significantly lower endophthalmitis incidences (total score > or = 8) than the BSS controls. Shield scores were not significantly different from those of the counterpart drops. The comparison between drops was not significant (P = .0513); the difference between shields (P = .0232) and the post-comparison Zymar versus BSS shields (P = .0021) were significant.

Conclusions: Topical therapy with gatifloxacin before and after intraocular bacteria challenge led to lower incidences of endophthalmitis in rabbits. Prophylaxis with presoaked collagen shields was not statistically different than that with topical drops.