Corneal intrastromal gatifloxacin crystal deposits after penetrating keratoplasty.
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.
Awwad
Shady T
ST
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.
Haddad
Walid
W
Wang
Ming X
MX
Parmar
Dipak
D
Conger
Darrel
D
Cavanagh
H Dwight
HD
D000368:Aged; D000369:Aged, 80 and over; D003316:Corneal Diseases / Q000175:diagnosis / Q000209:etiology*; D003319:Corneal Stroma / Q000187:drug effects* / Q000473:pathology; D003460:Crystallization; D004359:Drug Therapy, Combination; D024841:Fluoroquinolones / Q000009:adverse effects* / Q000627:therapeutic use; D000077734:Gatifloxacin; D015745:Granuloma, Foreign-Body / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D015948:Keratoplasty, Penetrating; D019654:Lens Implantation, Intraocular; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D009883:Ophthalmic Solutions; D011239:Prednisolone / Q000031:analogs & derivatives* / Q000627:therapeutic use
D024841:Fluoroquinolones; D009883:Ophthalmic Solutions; C009935:prednisolone acetate; D011239:Prednisolone; D000077734:Gatifloxacin