Intracameral Injection of Vigadexa and Corneal Endothelial Cell Loss

A new study published in the Graefe's Archive for Clinical and Experimental Ophthalmology suggests that intracameral injection of Vigadexa is not associated with a higher degree of corneal endothelial cell loss.

Intracameral antibiotics, such as moxifloxacin and cefuroxime, are safe for corneal endothelial cells and effective prophylaxis of endophthalmitis after cataract surgery. Corneal endothelial cells decrease in density after cataract surgery. Any substance used in the anterior chamber may affect corneal endothelial cells and lead to a greater decrease in density. This study aims to determine the percentage of endothelial cell loss after cataract extraction by phacoemulsification with off-label intracameral injection of moxifloxacin and dexamethasone (Vigadexa®).

Study Methodology

An observational retrospective study was performed. The clinical records of patients undergoing cataract surgery by phacoemulsification plus intracameral injection of Vigadexa® were analyzed. Endothelial cell loss (ECL) was calculated using preoperative and postoperative endothelial cell density. The relation of endothelial cell loss with cataract grade using LOCS III classification, total surgery time, total ultrasound time, total longitudinal power time, total torsional amplitude time, total aspiration time, estimated fluid usage, and cumulative dissipated energy (CDE) was studied using univariate linear regression analysis and logistic regression analysis.

Results

The median loss of corneal endothelial cells was 4.6%, with an interquartile range of 0 to 10.4%. Nuclear color and CDE were associated with increased ECL. ECL greater than 10% was associated with age and total ultrasound time in seconds.

The endothelial cell loss after the intracameral use of Vigadexa® at the end of cataract surgery was similar to that reported in other studies of cataract surgery without the use of intracameral prophylaxis for postoperative endophthalmitis (POE). This study confirmed the association of CDE and nuclear opalescence grade with postoperative corneal endothelial cell loss.

Reference

Galvis, V., Prada, A.M., Tello, A. et al. Safety of intracameral application of moxifloxacin and dexamethasone (Vigadexa®) after phacoemulsification surgery. Graefes Arch Clin Exp Ophthalmol 261, 3215–3221 (2023). https://doi.org/10.1007/s00417-023-06095-0

Keywords

• Intracameral
• Injection
• Vigadexa
• Associated
• Higher
• Degree
• Corneal
• Endothelial
• Cell
• Loss
• Galvis, V.
• Prada, A.M.
• Tello
• Graefe's Archive for Clinical and Experimental Ophthalmology