title: The effect of the fourth-generation fluoroquinolones on corneal reepithelialization after penetrating keratoplasty.
abstract: OBJECTIVE
  To compare the effects of topical moxifloxacin and gatifloxacin on corneal reepithelialization after penetrating keratoplasty.
  
  
  METHODS
  In this single-center, open-label, prospective study, 46 consecutive patients requiring penetrating keratoplasty were alternately assigned to receive either postoperative moxifloxacin 0.5% ophthalmic solution (n = 23; Vigamox) or gatifloxacin 0.3% ophthalmic solution (n = 23; Zymar). The primary outcome measure was the area of the epithelial defect measured by slit-lamp evaluation during the postoperative period.
  
  
  RESULTS
  The mean area of the epithelial defect was similar in both treatment groups at baseline (P = 0.104), but it was significantly larger in the moxifloxacin group than in the gatifloxacin group at day 4 (23.9 mm2 versus 10.6 mm2, respectively; P < .001) and day 7 (3.8 mm2 versus 0.85 mm2, respectively; P = 0.03). At every follow-up visit after day 4, there were more eyes with complete reepithelialization of the corneal graft in the gatifloxacin group than in the moxifloxacin group (statistically significant at days 7 and 14).
  
  
  CONCLUSIONS
  The results of this preliminary study suggest that the postoperative use of gatifloxacin in corneal transplant patients may allow the early stages of corneal graft reepithelialization to proceed more quickly than does treatment with moxifloxacin. These findings suggest that a larger, masked, randomized clinical study in a more homogeneous patient population is warranted to further investigate the relative effects of moxifloxacin and gatifloxacin on postoperative corneal wound healing.
authors.affiliation: Moran Eye Center, University of Utah, Salt Lake City, UT 84121, USA. moshirfar@worldnet.att.net
authors.forename: Majid
authors.initials: M
authors.lastname: Moshirfar
authors.forename: Douglas P
authors.initials: DP
authors.lastname: Marx
authors.forename: Rajiv
authors.initials: R
authors.lastname: Kumar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001372:Aza Compounds / Q000627:therapeutic use*; D002648:Child; D019573:Epithelium, Corneal / Q000187:drug effects* / Q000502:physiology; D015818:Eye Infections, Bacterial / Q000517:prevention & control; D005260:Female; D024841:Fluoroquinolones / Q000627:therapeutic use*; D000077734:Gatifloxacin; D006801:Humans; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D000077266:Moxifloxacin; D011182:Postoperative Care; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D011804:Quinolines / Q000627:therapeutic use*; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D000077734:Gatifloxacin; D000077266:Moxifloxacin