莫西沙星前房注射预防白内障术后细菌性眼内炎的研究进展

Research progress of intracameral moxifloxacin in the prevention of bacterial endophthalmitis after cataract surgery

白内障术后眼内炎(POE)是一种罕见的威胁视力的并发症,在我国的发病率为0.033%~0.11%。近几年有大量的病例对照研究和回顾性系列病例分析研究指出,白内障术毕前房注射抗生素可有效降低细菌性眼内炎的发生率,其中常用的药物包括头孢呋辛、万古霉素和莫西沙星。由于全球各地POE致病菌种类、抗生素的可获得性、成本效益等因素存在差异,药物的选择也存在很大差异。前房内注射抗生素引起的不良事件屡见发生,包括过量注射头孢呋辛导致的黄斑水肿、视网膜血管渗漏和葡萄膜炎,万古霉素引起出血性闭塞性视网膜血管炎等并发症。莫西沙星作为第4代氟喹诺酮类药物对细菌性眼内炎有明显的预防作用。本文着重归纳了近5年前房注射抗生素预防POE研究结果,就莫西沙星在细菌性眼内炎预防、药物安全性、前房药物持续时间以及成本效益方面进行综述。

Postoperative endophthalmitis(POE)is a serious vision-threatening complication of cataract surgery,with an incidence rate of 0.033%-0.11%in China.In recent years,numerous retrospective studies and data analyses have reported that intracameral injection of antibiotics can effectively reduce the incidence of bacterial endophthalmitis,which commonly include cefuroxime,vancomycin and moxifloxacin.Globally,due to factors such as the availability,cost-effectiveness,and types of pathogens of POE,the drug choice varies to a large extent.Adverse events caused by antibiotics in the intracameral injection often occur,including macular edema,retinal vascular leakage,and uveitis caused by overdose of cefuroxime,and complications such as hemorrhagic retinal vasculitis obliterans due to vancomycin.Moxifloxacin,as a fourth-generation fluoroquinolone,has a significant effect on the prevention of bacterial endophthalmitis.Studies in the past five years related to moxifloxacin,and the significant advantages of moxifloxacin in the prevention of bacterial endophthalmitis,drug safety,duration of intracameral drug,and cost-effectiveness were summarized in this article.