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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.

DOI:10.1097/01.icl.0000133241.56713.2f
PMID:15499240
Abstract

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.

摘要

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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引用本文的文献

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Corneal Deposits Following Combined Gatifloxacin and Prednisolone Therapy Post-Keratoplasty: A Report of a Rare Case.角膜移植术后加替沙星与泼尼松联合治疗后的角膜沉积物:1例罕见病例报告
Cureus. 2024 Jul 10;16(7):e64283. doi: 10.7759/cureus.64283. eCollection 2024 Jul.
2
Role of intrastromal vancomycin in recalcitrant corneal abscess after phacoemulsification.后超声乳化难治性角膜脓肿中基质内万古霉素的作用。
BMJ Case Rep. 2021 May 24;14(5):e241709. doi: 10.1136/bcr-2021-241709.
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New insight into non-healing corneal ulcers: iatrogenic crystals.
非愈合性角膜溃疡的新见解:医源性晶体。
Eye (Lond). 2013 Jun;27(6):755-62. doi: 10.1038/eye.2013.39. Epub 2013 Apr 5.
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Corneal deposit of ciprofloxacin after laser assisted subepithelial keratomileusis procedure: a case report.准分子激光上皮下角膜磨镶术术后环丙沙星角膜沉着物:一例报告
J Ophthalmol. 2010;2010:296034. doi: 10.1155/2010/296034. Epub 2010 Jun 16.