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Corneal Intrastromal Gatifloxacin Crystal Deposits After Penetrating Keratoplasty

Eye & Contact Lens: Science & Clinical Practice: July 2004 - Volume 30 - Issue 3 - pp 169-172

Awwad, Shady T. M.D; Haddad, Walid M.D; Wang, Ming X. M.D., Ph.D; Parmar, Dipak M.B.B.S., B.Sc.(Hons.), F.R.C.Ophth; Conger, Darrel C.R.A; Cavanagh, H Dwight M.D., Ph.D


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.

© 2004 Lippincott Williams & Wilkins, Inc.


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