Toxicity of Intracameral Injection of Fourth-Generation Fluoroquinolones on the Corneal Endothelium

Toxicity of Intracameral Injection of Fourth-Generation Fluoroquinolones on the Corneal Endothelium

Author Silva, Francisco Bandeira e Autor UNIFESP Google Scholar
Carrijo-Carvalho, Linda Christian Autor UNIFESP Google Scholar
Teixeira, Anderson Autor UNIFESP Google Scholar
Freitas, Denise de Autor UNIFESP Google Scholar
Carvalho, Fabio Ramos de Souza Autor UNIFESP Google Scholar
Abstract Purpose: The aim of this study was to compare the cellular susceptibility patterns and morphologic changes in the corneal endothelium associated with the use of fourth-generation fluoroquinolones. Method: Endothelial susceptibility was assessed through intracameral injection of besifloxacin, gatifloxacin, and moxifloxacin. Human umbilical vein endothelial cells (HUVECs) were used as the standard cellular lineage to assess the quantitative toxicity of each antibiotic solution. Qualitative changes in the morphologic character of the corneal structure and the endothelial layer were generated using a combination of ex vivo and in vivo assays. Experimental assays were conducted in triplicate, and the results were statistically analyzed. Results: At 1 hour of exposure, all HUVECs exposed to antibiotics showed viability above 85%, after 3 hours of exposure to besifloxacin, gatifloxacin, and moxifloxacin, the percentages of viable cells were 68.3 +/- 4.0 (P < 0.001), 90.7 +/- 4.2 (P < 0.05), and 93.3 +/- 1.5 (P > 0.05), respectively. All fluoroquinolones tested showed toxicity to HUVECs, resulting in significant (P < 0.001) loss of cellular viability after 24 hours of drug exposure. Giant endothelial cells were observed in animals treated with the 3 fluoroquinolones in contrast to the absence of these abnormal cells in the untreated group. Early cellular detachment was seen in the endothelial layer after exposure to gatifloxacin and moxifloxacin. Conclusions: We concluded that injection of fourth-generation fluoroquinolones in the aqueous humor did not adversely affect the corneal endothelium. However, these results suggested that prophylactic intracameral injection of besifloxacin, gatifloxacin, or moxifloxacin, if needed, should be administered as a last therapeutic resource in clinical practice, with careful and constant monitoring of corneal endothelium.
Keywords fourth-generation fluoroquinolones
cornea
endothelial cells
intracameral fluoroquinolone
xmlui.dri2xhtml.METS-1.0.item-coverage Philadelphia
Language English
Sponsor Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
PNPD/Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Young Researchers at Emerging Centers Program of Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
Grant number FAPESP: 2008/53969-0
FAPESP: 2011/51626-1
CAPES: 23038.001063/2012-01
FAPESP: 2012/15603-0
CNPq: 311612/2012-1
Date 2016
Published in Cornea. Philadelphia, v. 35, n. 12, p. 1631-1637, 2016.
ISSN 0277-3740 (Sherpa/Romeo, impact factor)
Publisher Lippincott Williams & Wilkins
Extent 1631-1637
Origin http://dx.doi.org/10.1097/ICO.0000000000000967
Access rights Closed access
Type Article
Web of Science ID WOS:000387863300030
URI https://repositorio.unifesp.br/handle/11600/56679

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