CORNEAL DEPOSITS ASSOCIATED WITH TOPICAL MOXIFLOXACIN

To report a case of corneal deposits from the use of moxifloxacin topical drops during treatment of a corneal ulcer. 

Deparment of Ophthalmology, General hospital "Dr Josip Benčević", Slavonski Brod, Croatia

A 92-year-old woman presented with deposits in the anterior corneal stroma during the treatment of corneal ulcer (Stapyloccocus aureus) in her right eye with moxifloxacin and chloramphenicol at another hospital. Clinical examination and slit-lamp photography were done.

The slit-lamp examination revealed circumcorneal congestion, a white plaque‑like lesion in the lower one-fourth of cornea with significant corneal opacity and rest of details were not clear. The best‑corrected visual acuity in her right eye was hand movement. She had phaco surgery in her right eye  12 years ago with postoperativly clear cornea. There was a history of ARMD sicca in her both eyes. Given her history of corneal ulcer and pain in her right eye we decided to treat the patient through the hospital. Adjuvant drugs were discontinued,  moxifloxacin drops was replaced with garamycin drops and chloramphenicol ointment for 7 days and lubricants were added. Microbiological culture conducted in our hospital was sterile so frequency of artificial tears instillation was increased. In literature, the  fluoroquinolone deposit usually disappears 3–4 weeks after discontinuation of the medication. The  patient had symptomatic improvement with partial resolution of the corneal deposits 4 weeks after discontinuation of moxifloxacin. A corneal white plaque‑like lesion completely resolved after 8 weeks resulting in an improvement in visual acuity to 1MC.

Sponatenous complete resolution of corneal deposits is observed after 8 weeks of discontinuing moxifloxacin drops without the need for surgical intervention.