穿透性角膜移植术后角膜基质内加替沙星晶体沉积
Corneal intrastromal gatifloxacin crystal deposits after penetrating keratoplasty.
作者信息
Awwad Shady T, Haddad Walid, Wang Ming X, Parmar Dipak, Conger Darrel, Cavanagh H Dwight
机构信息
Department of Ophthalmology (S.T.A., D.P., D.C., H.D.C.), University of Texas, Southwestern Medical Center at Dallas, Dallas, TX 75390-9057, USA.
出版信息
Eye Contact Lens. 2004 Jul;30(3):169-72. doi: 10.1097/01.icl.0000133241.56713.2f.
BACKGROUND
An 85-year-old man developed faint crystallike white precipitates in the mid peripheral stroma of his left cornea 3 weeks after undergoing penetrating keratoplasty. The patient had been initially treated with 1% prednisolone acetate ophthalmic suspension and 0.3% gatifloxacin eyedrops to his left eye from the first day postoperatively. Three weeks later, the precipitates were more numerous, larger, and diffuse in distribution. Gatifloxacin was discontinued and substituted with a neomycin-polymixin B-dexamethasone ophthalmic ointment.
METHODS
A detailed history, physical examination, laboratory workup, and tandem scanning confocal microscopy were performed.
RESULTS
Tandem scanning corneal confocal microscopy confirmed the presence of crystals in the cornea.
CONCLUSIONS
Gatifloxacin, a fourth-generation fluoroquinolone, can cause intrastromal macroscopic crystalline deposits through a compromised corneal epithelium, similar to what has been described for ciprofloxacin, a second-generation fluoroquinolone.
背景
一名85岁男性在穿透性角膜移植术后3周，其左眼周边基质中部出现了模糊的结晶样白色沉淀物。患者术后第一天起左眼最初接受1%醋酸泼尼松龙滴眼液和0.3%加替沙星滴眼液治疗。3周后，沉淀物数量增多、体积增大且分布更弥散。停用加替沙星，换用新霉素-多粘菌素B-地塞米松眼膏。
方法
进行了详细的病史询问、体格检查、实验室检查及串联扫描共焦显微镜检查。
结果
串联扫描角膜共焦显微镜检查证实角膜中存在晶体。
结论
加替沙星，一种第四代氟喹诺酮类药物，可通过受损的角膜上皮导致基质内出现宏观结晶沉积物，类似于第二代氟喹诺酮类药物环丙沙星所描述的情况。
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