Ocular toxicity of subconjunctival gentamicin.
The subconjunctival injection of commercial gentamicin, given either as a single dose or as repeated injections, caused a hyperemic conjunctival response. Simultaneously there was a toxic myopathy induced in the extraocular muscles. The overall response, followed with light microscopy, occurred as a focal infiltrate of polymorphonuclear leukocytes with progression over a few days to a mononuclear cell infiltrate that accompanied fiber degeneration. Injections of each ingredient of commercial gentamicin individually showed that only gentamicin caused the muscle response; methylparaben, EDTA, and sodium bisulfite were without effect. The pH of the solution was eliminated as a contributing factor as was osmolarity of the injection. Increasing recognition is being given to post-operative complications caused by the prophylactic subconjunctival injection of gentamicin following cataract, and other intraocular surgery. The present data offer a mechanistic explanation for many of these toxic findings.
Green
K
K
Department of Ophthalmology, Medical College of Georgia, Augusta 30912-3400.
Chapman
J
J
Cheeks
L
L
D000818:Animals; D003228:Conjunctiva; D003229:Conjunctival Diseases / Q000139:chemically induced; D005123:Eye / Q000187:drug effects*; D005839:Gentamicins / Q000633:toxicity*; D006470:Hemorrhage / Q000139:chemically induced; D006940:Hyperemia / Q000139:chemically induced; D007267:Injections; D009135:Muscular Diseases / Q000139:chemically induced; D009801:Oculomotor Muscles / Q000187:drug effects; D011817:Rabbits
D005839:Gentamicins