Acute effects of direct exposure to moxifloxacin on the porcine corneal endothelium: An ex vivo study.

Intracameral administration of an ophthalmic solution of moxifloxacin has been proposed as a prophylactic strategy for the prevention of postoperative endophthalmitis following intraocular surgery, especially after phacoemulsification. The present study evaluated the acute effects of direct exposure to moxifloxacin on the porcine corneal endothelium using a worst-case ex vivo exposure model. A total of 48 porcine corneas, obtained from six-month-old male pigs, were allocated into three experimental groups: group A (control; n = 24) received balanced salt solution applied directly to the endothelial surface; while groups B (n = 12) and C (n = 12) were treated with a 0.25% or 0.5% ophthalmic solution of moxifloxacin, respectively. Scanning electron microscopy (SEM) was used to identify areas of endothelial cell loss, which were quantified using ImageJ software. Although exposure to 0.5% moxifloxacin resulted in significant endothelial morphological changes consistent with cellular damage, no acute endothelial injury was observed following exposure to 0.25% moxifloxacin. Compared to the other groups, the mean endothelial cell loss for Group C was 27.83%. Direct exposure of the corneal endothelium to moxifloxacin ophthalmic solution at concentrations ≥0.5% may induce endothelial toxicity. Therefore, during intracameral administration, care should be taken to avoid direct contact between moxifloxacin and the corneal endothelium in order to minimize potential endothelial damage.