Evaluation of moxifloxacin penetration into corneal lenticules extracted during SMILE surgery.

Purpose: To evaluate the penetration of topically applied moxifloxacin 0.5% in corneal lenticule tissue collected from healthy patients undergoing the Kerato Lenticule Extraction (KLEx) surgery.

Methods: Thirty-seven eyes of 37 patients received a single drop of moxifloxacin 0.5% before corneal lenticule tissue collection in KLEx surgery. The lenticule samples were divided into three groups according to collection time. Eight lenticules (21.6%) were included in group 1 (0.5 to 1.0 h), 19 lenticules (51.3%) in group 2 (1.0 to 1.5 h), and 10 lenticules (27.0%) in group 3 (1.5 to 2.0 h). The lenticules were stored at -80 °C until analysis. Moxifloxacin concentration in the lenticule tissue was measured using a validated liquid chromatography mass spectrometry (LC-MS/MS) technique.

Results: The mean corneal lenticule concentration of moxifloxacin was 22.54 ± 13.63 μg/g in group 1, 17.8 ± 10.88 μg/g in group 2, and 9.88 ± 4.2 μg/g in group 3. These concentrations were higher than the minimum inhibitory concentration (MIC) values of bacterial isolates, except Pseudomonas aeruginosa.

Conclusion: This study demonstrates that a single preoperative drop of moxifloxacin 0.5% achieves corneal tissue concentrations above the MIC for most bacterial pathogens except Pseudomonas aeruginosa. These results suggest that such prophylactic administration may effectively reduce the risk of post-operative infection in patients undergoing KLEx surgery.