Efficient Penetration into Aqueous Humor by Administration of Oral and Topical Levofloxacin

Purpose: We investigated whether an optimized combination of oral and topical levofloxacin would lead to higher levofloxacin concentrations in aqueous humor. Methods: Fifteen patients with cataracts in both eyes began topical treatment at 1 week before the first surgery and oral treatment at 1 day before the first surgery. On the day of surgery, they received oral and topical levofloxacin at 4 h and 1 h before surgery, respectively. Two days after the first operation, we performed cataract surgery on the second eye with the same drug administration protocol. Results: Postsurgery concentrations of levofloxacin in the aqueous humor of the first and second eyes were 2.87±0.89 μg/mL (mean±standard deviation, n=15) and 3.76±1.32 μg/mL, respectively; the levofloxacin level in the second eye was significantly higher than that in the first eye (P=0.0085). Conclusions: Our protocol to achieve high aqueous humor concentrations of levofloxacin may be favorable in preventing endophthalmitis after eye surgery.