Dear Dr. Feijó,
We thank you for your analysis of our submitted manuscript. Our prospective study showed that moxifloxacin is safe for intracameral use, in agreement with previous studies. Notably, previous related studies included small numbers of patients or use of retrospective methodology(1,2).
On the basis of your estimate that it would be necessary to treat 1.111 patients with intracameral moxifloxacin to prevent one case of endophthalmitis, and on the basis of the additional cost of US $0.50 (syringe + drug), we conclude that an investment of less than US $1.00 per patient would allow clinicians to reduce the incidence of an extremely serious illness that can lead to expensive lawsuits.
We believe this prophylaxis is cost-effective. However, a prospective, randomized clinical trial is necessary to ratify these observations.
Regards,
de Paiva Lucena N, et al.
REFERENCES
1. Cavalcanti Lira RP, Lucena NP, Ferreira KS, dos Santos BM. Long-term safety of intracameral moxifloxacin after cataract surgery. J Cataract Refract Surg. 2017;43(1):139-40. doi: 10.1016/j.jcrs.2016.11.040.
2. Haripriya A, Chang DF. Intracameral antibiotics during cataract surgery: evidence and barriers. Curr Opin Ophthalmol. 2018;29(1): 33-9.
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