Kamiya Kazutaka, Kitahara Miyuki, Shimizu Kimiya
Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan.
Cornea. 2009 Jan;28(1):114-5. doi: 10.1097/ICO.0b013e3181822667.
To report on severe visual impairment in a patient with decreased tear secretion in whom dense corneal deposits resulted from tosufloxacin treatment after cataract surgery.
An 86-year-old woman complained of blurred vision in the left eye. She had been treated with topical applications of tosufloxacin, betamethasone, and diclofenac sodium, all administered 4 times a day as a regimen lasting for 1 month after cataract surgery. In that eye, the best spectacle-corrected visual acuity was 20/200 due to the dense deposits on the cornea. The Schirmer test showed a decrease in basic tear secretion (right eye 2 mm, left eye 1 mm). We removed these deposits surgically and analyzed them by infrared spectrophotometry.
The best spectacle-corrected visual acuity markedly improved, to 20/25, after surgical removal of the deposits in the left eye. The spectrophotometric pattern of the deposits was consistent with that of tosufloxacin.
Topical application of tosufloxacin may lead to fluoroquinolone drug deposition on the cornea, especially when an antibiotic drug has been used continuously in patients with poor tear secretion.
报告一例白内障手术后因妥舒沙星治疗导致泪液分泌减少且角膜出现致密沉积物的患者出现严重视力损害的情况。
一名86岁女性主诉左眼视力模糊。白内障手术后，她接受了妥舒沙星、倍他米松和双氯芬酸钠的局部应用治疗，均为每日4次，持续1个月。在该眼中，由于角膜上的致密沉积物，最佳矫正视力为20/200。泪液分泌试验显示基础泪液分泌减少（右眼2毫米，左眼1毫米）。我们通过手术切除这些沉积物，并采用红外分光光度法对其进行分析。
左眼手术切除沉积物后，最佳矫正视力显著提高至20/25。沉积物的分光光度模式与妥舒沙星一致。
局部应用妥舒沙星可能导致氟喹诺酮类药物在角膜上沉积，尤其是在泪液分泌不良的患者中持续使用抗生素药物时。
