Katahira Haruki, Kumakura Shigeto, Hattori Takaaki, Goto Hiroshi
Department of Ophthalmology, Tokyo Medical University, Shinjukuku, Tokyo, Japan.
Int Med Case Rep J. 2017 Jul 13;10:239-241. doi: 10.2147/IMCRJ.S132531. eCollection 2017.
To report the adverse event of topical tosufloxacin administered after penetrating keratoplasty in one patient.
A 60-year-old female was referred to our hospital for treatment of vision loss due to corneal opacification, etiology was unknown. Slit lamp examination showed dense opacification in corneal stroma. Penetrating keratoplasty was performed on her left eye. She was treated with topical applications of 1.5% levofloxacin, 0.5% cefmenoxime, 0.1% betamethasone, 0.1% hyaluronate sodium, and 3% aciclovir after penetrating keratoplasty. Delayed epithelialization of the donor graft was observed at day 4 post-transplantation. Because of the concern that levofloxacin induced corneal epithelialization delay, 1.5% levofloxacin was changed to 0.3% tosufloxacin. At day 6 post-transplantation, deposits on the epithelial defect of the donor graft were observed. Tosufloxacin was suspected to be the cause of deposits, and tosufloxacin eye drop was discontinued. The deposits decreased gradually and completely disappeared by 5 months post-transplantation.
Topical tosufloxacin treatment has the risk of precipitation on compromised corneas such as corneal grafts with epithelial defect after penetrating keratoplasty. After discontinuation of therapy, the deposit may resolve spontaneously without surgical removal.
报告1例穿透性角膜移植术后局部应用妥舒沙星的不良事件。
一名60岁女性因角膜混浊导致视力丧失（病因不明）转诊至我院。裂隙灯检查显示角膜基质致密混浊。对其左眼实施穿透性角膜移植术。穿透性角膜移植术后，她接受了局部应用1.5%左氧氟沙星、0.5%头孢甲肟、0.1%倍他米松、0.1%透明质酸钠和3%阿昔洛韦的治疗。移植术后第4天观察到供体植片上皮化延迟。由于担心左氧氟沙星导致角膜上皮化延迟，将1.5%左氧氟沙星更换为0.3%妥舒沙星。移植术后第6天，观察到供体植片上皮缺损处有沉积物。怀疑沉积物是由妥舒沙星引起的，遂停用妥舒沙星滴眼液。沉积物逐渐减少，至移植术后5个月完全消失。
局部应用妥舒沙星治疗存在在受损角膜（如穿透性角膜移植术后有上皮缺损的角膜植片）上形成沉淀的风险。停药后，沉积物可能会自行消退，无需手术清除。
