Intracameral use of Moxifloxacin in Prevention of Endophthalmitis after Cataract Surgery in a Tertiary Care Centre

Introduction: Postoperative endophthalmitis is a rare but vision-threatening complication of cataract surgery. The use of intracameral antibiotics, particularly moxifloxacin, has gained attention as a preventive measure due to its broad-spectrum coverage and safety profile. Aim & Objective: To determine the incidence of postoperative endophthalmitis following cataract surgery and to evaluate the preventive efficacy of intracameral moxifloxacin. Material & Methods: This prospective observational study was conducted over 18 months in a tertiary care ophthalmology department and included 2000 patients undergoing cataract surgery by a single surgeon to ensure consistency. Patients were divided into two groups: 1000 received intracameral moxifloxacin and 1000 served as controls. Adults above 18 years providing written consent were included, while those with traumatic or complicated cataracts, combined surgeries, or intraoperative complications were excluded. Data on demographics, intraoperative events, and postoperative infection were analyzed using STATA software. Result: The overall incidence of postoperative endophthalmitis was 0.25% (5/2000 patients). Among those, one case occurred in the moxifloxacin group and four in the control group. Most patients (over 90%) had uneventful surgeries, while posterior capsule rent was observed in 7–8% of cases. Causative organisms included Streptococcus pneumoniae and Pseudomonas aeruginosa. All affected patients presented with pain, lid edema, corneal edema, and hypopyon, with visual outcomes ranging from 6/60 to no light perception. Conclusion: The study observed a low incidence of postoperative endophthalmitis consistent with global data. Although intracameral moxifloxacin did not show a statistically significant reduction in infection rates, it remains a safe adjunct. Posterior capsule rent was a key risk factor, emphasizing meticulous surgical technique and infection control.