Effect of Gatifloxacin Ophthalmic Solution 0.3% on Human Corneal Endothelial Cell Density and Aqueous Humor Gatifloxacin Concentration

Abstract

Purpose: To evaluate the effect of gatifloxacin ophthalmic solution 0.3% (Zymar, Allergan, Inc., Irvine, CA, USA) on corneal endothelial cell density and morphology and to measure gatifloxacin penetration into aqueous humor. Methods: This was a single-center, open-label clinical study. Ten patients undergoing standard cataract surgery and 20 nonsurgical subjects instilled gatifloxacin 0.3% four times per day for 2 days, then every 10 min for 1 hr on the third day (the surgery day for the cataract patients). Corneal endothelial cells were counted using noncontact specular microscopy. Anterior chamber fluid was withdrawn from the surgical patients, and the gatifloxacin concentration was quantified by high-pressure liquid chromatography. Results: Baseline endothelial cell counts (mean ± SD) were 2400 ± 442 in the surgical group and 2520 ± 212 in the nonsurgical group. The mean differences from baseline 1 hr after the last dose of gatifloxacin 0.3% were −51 ± 213 (p = 0.23) in the surgical group and −7 ± 150 (p = 0.42) in the nonsurgical group. In the nonsurgical group, the mean difference from baseline 3 weeks after the last dose was 18 ± 147 (p = 0.71). The mean concentration (± SD) of gatifloxacin in aqueous humor was 1.26 ± 0.55 μ g/ml. Conclusions: A preoperative, prophylactic course of gatifloxacin 0.3% ophthalmic solution did not significantly affect endothelial cell density or morphology, while meaningful drug concentration was achieved in the aqueous humor.

KEYWORDS:

• aqueous humor concentration
• cataract surgery
• corneal endothelial cell density
• corneal toxicity
• gatifloxacin ophthalmic solution