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Toxicity comparison of intraocular azithromycin with and without a bioadhesive delivery system in rabbit eyes.

Author(s): Goecks T, Werner L, Mamalis N, Fuller SR, Jensen M, Kavoussi SC, Hill M, Olson RJ

Affiliation(s): From the University of Vermont College of Medicine (Goecks), Burlington, Vermont, and the Department of Ophthalmology and Visual Sciences (Werner, Mamalis, Fuller, Jensen, Kavoussi, Hill, Olson), John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA.

Publication date & source: 2011-11-09, J Cataract Refract Surg., [Epub ahead of print]

PURPOSE: To determine whether the addition of a bioadhesive drug-delivery system to topical azithromycin induces intraocular inflammation and damage when introduced intraocularly by different approaches and in varying doses. SETTING: John A. Moran Eye Center, Salt Lake City, Utah, USA. DESIGN: Experimental study. METHODS: Commercial topical azithromycin 1.0% was duplicated, including the benzalkonium chloride, but without inclusion of the Durasite bioadhesive drug-delivery system. Injections of 50 muL, 25 muL, and 10 muL of the antibiotic solutions were administered in a masked fashion to 2 rabbits; 1 eye (study eye) in each rabbit was randomized to receive azithromycin with the delivery system and the fellow eye (control eye) to receive azithromycin without the delivery system. Two rabbits had topical drops of each solution placed after a 2.8 mm incision was created. Masked slitlamp examinations, pachymetry, and intraocular pressure (IOP) were determined 1 day and 2 days postoperatively. The animals were humanely killed, and the endothelial density and histopathology were examined. RESULTS: The IOP (P<.001), pachymetry (P<.001), and signs of inflammation (P=.38 to .003) were consistently higher in the study eye, especially at the 50 muL dose, than in the control eye. This was confirmed by histopathology. CONCLUSION: If the drug-delivery system gains access to the anterior chamber, it may cause substantial corneal edema and inflammation, even at low doses and after topical administration. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned. Copyright (c) 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Page last updated: 2011-12-09

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