{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T15:52:20Z","timestamp":1777909940313,"version":"3.51.4"},"reference-count":29,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2020,11,1]],"date-time":"2020-11-01T00:00:00Z","timestamp":1604188800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Ocular Pharmacology and Therapeutics"],"published-print":{"date-parts":[[2020,11,1]]},"abstract":"<jats:p>In our University journal club we discussed a large, retrospective study of cataract surgery endophthalmitis rates before and after instituting the use of an intracameral fluoroquinolone antibiotic. We identified several factors involved in the use of off-label, compounded moxifloxacin in intraocular surgery. The introduction of phacoemulsification for cataract surgery led to the potential for smaller incisions. Intraocular lens technology improved to allow for foldable lenses, obviating the requirement to enlarge the incision. This allowed for clear corneal incisions, which unfortunately allow bidirectional passage of liquid. Preservatives were introduced into multi-dose ophthalmic products in the mid 20th century to retard microbial growth. However, more recently, chronic use of benzalkonium chloride has led to concerns about concerns about conjunctival toxicity, especially in patients with ocular surface disease. In the formulation of ocular moxifloxacin, developers were able to develop a \u201cself-preserved\u201d, multi-dose product. Other concerns with eyedrops include varying levels of adherence and performance, and the expansion of compounding pharmacies from a named-patient basis to widespread national delivery, with concerns for lower quality. Integrating these factors, use of intracameral moxifloxacin as a prophylactic during cataract and other anterior segment surgery has become a standard of care in much of the U.S. We are concerned that the current position is on a narrow ledge-the standard of care for millions of surgeries each year based upon off-label, compounting use of a single product. We discuss possible ramifications and solutions to this public health issue.<\/jats:p>","DOI":"10.1089\/jop.2020.0034","type":"journal-article","created":{"date-parts":[[2020,6,24]],"date-time":"2020-06-24T21:40:46Z","timestamp":1593034846000},"page":"668-671","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Peri-Operative Intracameral Antibiotics: The Perfect Storm?"],"prefix":"10.1177","volume":"36","author":[{"given":"Gary D.","family":"Novack","sequence":"first","affiliation":[{"name":"Department of Ophthalmology &amp; Visual Sciences, University of California, Davis, California, USA."},{"name":"PharmaLogic Development, Inc., San Rafael, California, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey J.","family":"Caspar","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology &amp; Visual Sciences, University of California, Davis, California, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,11,5]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2019.04.018"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2017.01.026"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2019.07.025"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0886-3350(97)80299-4"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.123.5.643"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2005.02.059"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2007.02.032"},{"key":"e_1_3_4_9_2","first-page":"34S","article-title":"Clinical evaluation of ciprofloxacin 0.3% ophthalmic solution for treatment of bacterial keratitis","volume":"112","author":"Leibowitz H.M.","year":"1991","unstructured":"Leibowitz H.M. Clinical evaluation of ciprofloxacin 0.3% ophthalmic solution for treatment of bacterial keratitis. Am. J. Ophthalmol. 112 (Suppl):34S\u201347S, 1991.","journal-title":"Am. J. Ophthalmol"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.76.12.714"},{"key":"e_1_3_4_11_2","first-page":"137","article-title":"The contamination of fluorescein solutions, with special reference to Pseudomonas aeruginosa (bacillus pyocyaneus)","volume":"34","author":"Vaughan D.G.","year":"1953","unstructured":"Vaughan D.G.Jr. The contamination of fluorescein solutions, with special reference to Pseudomonas aeruginosa (bacillus pyocyaneus). Trans. Pac. Coast Otoophthalmol. Soc. Annu. Meet. 34:137\u2013149, 1953.","journal-title":"Trans. Pac. Coast Otoophthalmol. Soc. Annu. Meet"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9394(77)90849-2"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1542-0124(12)70131-3"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.129.6.513"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/009286158802200310"},{"key":"e_1_3_4_16_2","first-page":"159","article-title":"Electronic monitoring of medication compliance in depressed outpatients","volume":"45","author":"Engstrom F.W.","year":"1989","unstructured":"Engstrom F.W., , and Urquhart J. Electronic monitoring of medication compliance in depressed outpatients. Clin. Pharmacol. Ther. 45:159, 1989.","journal-title":"Clin. Pharmacol. Ther"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-pharmtox-011711-113247"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9394(14)74225-4"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9394(86)90939-6"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2007.06.012"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9394(86)90940-2"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.2008.297"},{"key":"e_1_3_4_23_2","unstructured":"Anonymous. Drug Supply Chain Security Act (DSCSA) 2020 [12 March 2020]. Available from: https:\/\/www.fda.gov\/drugs\/drug-supply-chain-integrity\/drug-supply-chain-security-act-dscsa. accessed June10 2020."},{"key":"e_1_3_4_24_2","unstructured":"Anonymous. FDA takes efforts to improve quality of compounded drugs from outsourcing facilities through collaboration and education as part of new Center of Excellence 2020. Available from: https:\/\/www.fda.gov\/news-events\/press-announcements\/fda-takes-efforts-improve-quality-compounded-drugs-outsourcing-facilities-through-collaboration-and. accessed June10 2020."},{"key":"e_1_3_4_25_2","first-page":"154","article-title":"Adjunctive antifibrotic therapy with mitomycin C and 5-fluorouracil: a review of their use in glaucoma surgery and considerations around ophthalmic compounding","volume":"2","author":"Fiscella R.","year":"2019","unstructured":"Fiscella R., , Leiter C., , Massomi F., , Noecker R., , and Sheybani A. Adjunctive antifibrotic therapy with mitomycin C and 5-fluorouracil: a review of their use in glaucoma surgery and considerations around ophthalmic compounding. Curr. Trends Ophthalmol. 2:154\u2013169, 2019.","journal-title":"Curr. Trends Ophthalmol"},{"key":"e_1_3_4_26_2","unstructured":"Anonymous. U.S. Illnesses and Deaths Associated With Compounded or Repackaged Medications 2001-19. 2020. Available from: https:\/\/www.pewtrusts.org\/en\/research-and-analysis\/data-visualizations\/2020\/us-illnesses-and-deaths-associated-with-compounded-or-repackaged-medications-2001-19 accessed June10 2020."},{"key":"e_1_3_4_27_2","first-page":"CD006364","article-title":"Perioperative antibiotics for prevention of acute endophthalmitis after cataract surgery","volume":"2","author":"Gower E.W.","year":"2017","unstructured":"Gower E.W., , Lindsley K., , Tulenko S.E., , Nanji A.A., , Leyngold I., , Mcand Donnell P.J. Perioperative antibiotics for prevention of acute endophthalmitis after cataract surgery. Cochrane Database Syst. Rev. 2:CD006364, 2017.","journal-title":"Cochrane Database Syst. Rev"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtos.2019.05.002"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2019.08.026"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-019-04417-9"}],"container-title":["Journal of Ocular Pharmacology and Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/jop.2020.0034","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/jop.2020.0034","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/jop.2020.0034","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T14:44:04Z","timestamp":1777646644000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/jop.2020.0034"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,1]]},"references-count":29,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2020,11,1]]}},"alternative-id":["10.1089\/jop.2020.0034"],"URL":"https:\/\/doi.org\/10.1089\/jop.2020.0034","relation":{},"ISSN":["1080-7683","1557-7732"],"issn-type":[{"value":"1080-7683","type":"print"},{"value":"1557-7732","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,1]]}}}