COMPARATIVE EFFICACY OF INTRACAMERAL 0.5% MOXIFLOXACIN VERSUS 0.1% CEFUROXIME IN PREVENTING POSTOPERATIVE ENDOPHTHALMITIS FOLLOWING PHACOEMULSIFICATION CATARACT SURGERY: A RANDOMIZED CONTROLLED TRIAL

Background: Postoperative endophthalmitis is an uncommon but vision-threatening complication of cataract surgery that can result in serious ocular morbidity if not prevented or treated promptly. Intracameral antibiotic prophylaxis has become an important preventive strategy in modern phacoemulsification surgery. Cefuroxime and moxifloxacin are commonly used agents, but comparative local evidence remains limited. This study was conducted to compare their prophylactic efficacy in preventing postoperative endophthalmitis after cataract surgery. Objective: To compare the efficacy of intracameral 0.5% moxifloxacin and intracameral 0.1% cefuroxime in preventing postoperative endophthalmitis following phacoemulsification cataract surgery. Methods: This randomized controlled trial was conducted at the Institute of Ophthalmology, Mayo Hospital, Lahore, over six months from 27 June 2022 to 27 December 2022. A total of 60 patients aged 50–70 years undergoing phacoemulsification cataract surgery were enrolled through non-probability consecutive sampling and randomly allocated into two equal groups by lottery method. Group A received intracameral cefuroxime 1 mg in 0.1 mL saline, while Group B received intracameral moxifloxacin 100 µg in 0.1 mL saline at the end of surgery. Patients were followed for six weeks postoperatively to assess prophylactic efficacy. Data were analyzed using SPSS version 25, with p≤0.05 considered statistically significant. Results: The mean age was 60.13 ± 5.84 years in the cefuroxime group and 59.56 ± 5.41 years in the moxifloxacin group. Mean disease duration was 2.33 ± 0.80 weeks and 2.36 ± 0.72 weeks, respectively, with no significant difference (p=0.866). In the cefuroxime group, 11 patients were male and 19 were female, while in the moxifloxacin group, 16 were male and 14 were female (p=0.299). Efficacy was achieved in 20 patients in the cefuroxime group and 28 patients in the moxifloxacin group, showing a statistically significant difference (p=0.021). Conclusion: Intracameral moxifloxacin demonstrated higher prophylactic efficacy than intracameral cefuroxime in preventing postoperative endophthalmitis after phacoemulsification cataract surgery. These findings support its potential use as an effective intracameral antibiotic option in routine cataract surgery. Keywords: Anti-Bacterial Agents; Cataract Extraction; Cefuroxime; Endophthalmitis; Moxifloxacin; Phacoemulsification; Postoperative Complications.