Year : 1983 | Volume
: 31 | Issue : 5 | Page : 645--647
Intraocular penetration of carbenicillin gentamicin and chloramphenicol with 'Sauflon 85' soft contact lenses
MR Jain, Shree Lal
Department of Ophthalmology, R.N.T. Medical College, Udaipur, India
M R Jain
Department of Ophthalmology, R.N.T. Medical College, Udaipur
|How to cite this article:|
Jain M R, Lal S. Intraocular penetration of carbenicillin gentamicin and chloramphenicol with 'Sauflon 85' soft contact lenses.Indian J Ophthalmol 1983;31:645-647
|How to cite this URL:|
Jain M R, Lal S. Intraocular penetration of carbenicillin gentamicin and chloramphenicol with 'Sauflon 85' soft contact lenses. Indian J Ophthalmol [serial online] 1983 [cited 2020 Jan 22 ];31:645-647
Available from: http://www.ijo.in/text.asp?1983/31/5/645/36618
Ocular drug therapy with soft contact lenses as a vehicle is more recent method ,,,, and is becoming more effective and more popular with the introduction of high water content lenses specially manufactured for drug delivery  .
Material and Methods
In the present study, 173 cases of uncomplicated cataract (admitted in the hospital for cataract surgery) were the subject matter of this study. The cases were free of any systemic or metabolic disease and were not receiving any antibiotic locaily or systemically.
The cases were divided into three groups depending upon the antibiotic used.
Group I-63 cases.
Carbenicillin Sodium was used in two strengths.
a) 21 cases-250 mg of drug dissolved in 0.5 ml of distilled water.
b) 42 cases-50 mg of drug dissolved in 0.5 ml of distilled water.
Group II-60 cases.
Gentamicin sulphate 20 mg in 0.5 ml of distilled water.
Group III-50 cases.
Chloramphenicol 50 mg dissolved in 0.5 ml of distilled water.
The lenses used were `Sauflon 85' drug delivery lenses. These lenses were afocal, of uniform diameter and uniform thickness but their back central curvature varied, depending upon the optimum fit to the patient's eyes.
The selected lens was soaked into antibiotic solution under study for half an hour and then applied on to the anterior segment of patient's eye. The lens was kept in position for half an hour and removed. After removal of the lens, the aqueous samples were collected in eye O.T. just before cataract operation at various time intervals ranging from 1/4 to 6 hours. Each group was further divided into six sub-groups depending upon dose to sample interval.
Aqueous aspirated was assayed for the concentration of respective antibiotic by modified disc diffusion method , utilizing Grove and Randall medium No. 5 and suspension of spores of B. Subtilis NCIm 2063.
The age in overall cases ranged from 40 to 80 years and the sex incidence was almost equal.
[Figure 1] shows that carbenicillin attains very high concentration of 158.08 + 12.05 ug/ml in the first sample collected at 15 mt. interval and the peak concentration of 452.50 + 5.0 ug/ml was attained in half hour samples. Two hour samples showed high concentration of 122.5 ± 1.0 ug/ml but 4 hour sample showed absence of drug.
However the lenses soaked with this high concentration of antibiotic produced unusual high incidence of keratitis and hence in the rest of the cases, 50 mg drug concentration was used.
With 50 mg drug dose, the peak concentration obtained was 148.60 ± 26.64 ug/ml at 15 mt. interval and least concentration of 28.0 ± 9.4 ug/ml was obtained at 2 hour interval. No incidence of keratitis was noticed.
[Figure 2] shows the pattern of gentamicin penetration into aqueous. It is noted that peak concentration of 35.25 + 0.75 ug/ml is obtained at 1 /2 hour interval and minimal degree of penetration is continued even upto 6 hours.
[Figure 3] shows peak penetration of drug at . 1/2 an hour interval samples and 4 hour samples showed minimal concentration of 4.66 +. 1.25 ug/ml.
In gentamicin or chloramphenicol group, no incidence of keratitis or any discomfort was noticed.
The promtness of the effective and peak concentration of the drug and the duration of drug availability are the important parameters which make an ophthalmic surgeon decide the mode of therapy in intraocular infections due to their potentiality to lead to complete blindness.
Hydrophilic soft contact lenses as an adjuant to drug delivery have been reckoned for the last decade or so ,,,, and the results have been very encouraging. Most of previous workers15 used Saufion 70 lenses and the drug used were pilocarpine, dexamethasone, carbenicillin and chloramphenicol.
Drug delivery lenses with high water content of 85 per cent or so are recent introduction. It is reckoned that the higher the water content of a lens, larger is the pore size between the polymer molecules and proportionally more antibiotic solution would be absorbed and gradually released when kept in contact with the eyes.
Our results of present study are tabulated [Table 1] and compared with our previous studies using Sauflon 70 or subconjunctival injections ,,, .
In carbenicillin group, with uniform doses of 50 mg subconjunctivally and Saufion 70 groups, both give almost equal peak concentration of 80.5 and 81.9 ug/ml respectively. Whereas 'Sauflon 85' group gave peak concentration of 148.60 ug/ml., which is far higher.
Similarly, gentamicin study show that maximum concentration reached with sub conjunctival injection was 14.82 ug/ml. Whereas with Sauflon 82' group, it is 35.25 ug/ml, which is more than double that of subconjunctival group.
As regards chloramphenicol group, the figures for peak concentration with subconjunctival injection and 'Sauflon 70' series are 16.24 and 19.35 respectively. Whereas, Sauflon 85 group shows for higher concentration of 29.75 ug/ ml.
With a look at the table, it can be easily concluded that Sauflon 85 provides prompt and distinctly higher drug concentration with all antibiotics. As regards duration of drug availability is concerned, subconjunctival injection provides drug for longer duration as compared to both Sauflon groups, though with Sauflon 85 drug penetration lasts longer than Sauflon 70.
Minimum effective concentration as regards three studied antibiotics against commonly affecting ocular pathogens namely Staphaureus., Prot. Supp., Ps. aeru., E. Coli etc.. is shown in [Figure 4] and it shows comparative duration of effective drug penetrationn against common ocular pathogens. It is noticed that all the three antibiotics attain effective concentration against Staph & E. Coli but effective concentration against Ps. aerugenosa is attained by only gentamicin and carbenicillin. Maximum duration of effectiveness against Ps. aerugenosa is provided by gentamicin sulphate.
|1||Kaufman, E., Liotilo, M.H., Gasset, A.R., & Ellison, E.D., Trans. Acad. Opth. & Oto., 75, 361-373, 1971.|
|2||Hillman, J.S., Br. J. Ophth., 58, 674, 1974.|
|3||Marmion, V.J., & Jain, M.R., Trans. Ophrh. Soc. U.K. Vol. XCY part II. 96, 319, 1976.|
|4||Jain, M.R., & Batra, V., Ind. J. Ophthal., 11, 26, 1979.|
|5||Jain, M.R., & Singhal, M., Proceeding Indian J. of Ophthal. at Manipal, (Under publication), 1980.|
|6||Jain, M.R., & Srivastava, S., Trans..O.SU.K. (London), 98, 63, 1978.|
|7||Jain, M.R., & Bansal, V.D., Proceedings of All India Ophthalmological Conference held at Amritsar, (Under publication), 1974.|
|8||Jain, M.R., & Modi, R., Proceedings of All India Ophthal. Conference held at Manipal, (Under publication). 1980.|