Pefloxacin
M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson in Kucers’ The Use of Antibiotics, 2017
Overall, fluoroquinolones are relatively safe in terms of ocular toxicity, although when this kind of toxicity occurs it appears to be dose-dependent and results from drug class effects and specific fluoroquinolone structures. Toxic effects of fluoroquinolones on ocular collagen may in some cases be associated with Achilles tendinopathy. Corneal precipitation may provide an advantageous drug depot but delay healing and result in corneal perforation in approximately 10% of cases. The current recommended safe dose for intravitreal injections of pefloxacin is 200 μg/0.1 ml (Thompson, 2007).
Small-Molecule Targeted Therapies
David E. Thurston, Ilona Pysz in Chemistry and Pharmacology of Anticancer Drugs, 2021
Finally, it is worth noting that skin rashes are the most common adverse reactions associated with EGFR inhibitors, and many clinicians believe that this may be a useful biomarker of drug activity. However, sometimes this effect can be very harmful to patients, and cases of keratitis and ulcerative keratitis have been reported following treatment with EGFR inhibitors including erlotinib, gefitinib cetuximab, and panitumumab. In rare cases, this has resulted in corneal perforation and blindness.
SKILL Apply corneal glue
Sam Evans, Patrick Watts in Ophthalmic DOPS and OSATS, 2014
A corneal perforation may be a consequence of trauma, infection or inflammation. Adequately closing the leak is important to reduce the risk of intraocular infection. Gluing may also help to control the progress of inflammatory corneal melt.
Microbial keratitis following intracorneal ring implantation
Published in Clinical and Experimental Optometry, 2019
Seyed Ali Tabatabaei, Mohammad Soleimani, Masoud Mirghorbani, Zahra Fallah Tafti, Firoozeh Rahimi
As stated previously, morbidity is high in post‐ICR implantation keratitis. Ring removal was performed in all affected eyes. Also, tunnel or pocket irrigation was undertaken using vancomycin 1 mg/0.1 cc. In the present study, five patients (45 per cent) needed a tectonic procedure (two PKPs and three AMTs). There were two cases of corneal perforation, both of which were caused by Staphylococcus aureus. PKP was performed in these cases. Three additional cases underwent AMT (as a tectonic procedure) because of severe thinning. Visual outcomes would be significantly decreased in post‐ICR keratitis compared to non‐complicated cases, especially in short‐term follow‐up. However, it seems that proper management of these patients would result in acceptable visual outcomes over time (Table 3).
Voriconazole Induced Ocular Surface Dysplasia – Report of Two Cases
Published in Ocular Immunology and Inflammation, 2022
Mamta Agarwal, Gayatri S, Subramanian Krishna Kumar, Rama Rajagopal
A 78-year-old immunocompetent man presented with decreased vision, pain, and redness in his left eye for the last 6 months. He was diagnosed as fungal keratitis elsewhere and treated with topical voriconazole 1% and itraconazole 1% for 6 months. On examination, BCVA in the right eye was 20/20 and in the left eye was hand movements close to face. Slit-lamp examination in the left eye showed central corneal perforation with epithelized iris tissue and flat anterior chamber (Figure 2a). Patient underwent therapeutic penetrating keratoplasty (Figure 2b). Histopathology of the host corneal tissue showed squamous cells with irregular thickening with dyskeratotic cells and squamous eddies suggestive of voriconazole induced dysplasia (Figure 2ce). It did not reveal any fungal filaments in the host corneal tissue. Postoperative period was uneventful. At last, follow-up after 9 months, graft was clear without any recurrence of infection or dysplasia.
Peripheral Ulcerative Keratitis Secondary to the Inactive COVID-19 Vaccine-CoronaVac
Published in Ocular Immunology and Inflammation, 2023
Management of PUK often requires systemic therapy targeting the underlying immunological process including nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, systemic immunosuppressive chemotherapy and biological therapy.26 Surgical treatment is necessary when corneal perforation occurs, procedures that employ cyanoacrylate glue, lamellar patch flap, or penetrating keratoplasty.4 Conjunctival resection of the inflamed area, conjunctival flap, and amniotic membrane transferring can accelerate the healing process with anti-inflammatory effectivity.28 Topical therapy with corticosteroids and immunosuppressive agents like cyclosporine are needed for regressing the stromal infiltrations and inflammation. But they could inhibit new collagen production and thereby increase the risk of perforation, so they must be used carefully.29 Despite all the systemic and topical medications and conservative surgical procedures the penetrant keratoplasty could be necessary for visual rehabilitation or tectonic reasons.
Related Knowledge Centers
- Cornea
- Physical Examination
- Pellucid Marginal Degeneration
- Seidel Test