Increaed incidence of corneal perforation after topical fluoroquinolone treatment for microbial keratiti

PURPOE: To compare the incidence of corneal perforation in eye treated with topical fluoroquinolone or fortified antibiotic for microbial keratiti. METHOD: A retropective medical record review of patient hopitalized for bacterial keratiti from January 1991 through November 1999. REULT: Two hundred eventy-even cae of bacterial keratiti were identified. The incidence of corneal perforation wa ignificantly higher in fluoroquinolone-treated eye (18 out of 142, 12.7%) compared with eye treated with fortified antibiotic (1 out of 135, 0.7%) (chi-quare = 13.6, degree of freedom (df) = 2, P < .001). Within the fluoroquinolone-treated group, all corneal perforation occurred in thoe eye treated with ofloxacin (18 out of 125, 14.4%). Corneal perforation that occurred in the ofloxacin-treated eye were not aociated with any particular microbial iolate. CONCLUION: Our data ugget an increaed rik of corneal perforation after fluoroquinolone treatment for bacterial keratiti compared with treatment with fortified antibiotic. Further tudie are warranted to verify thi aociation and etablih poible mechanim by which topical fluoroquinolone may alter corneal collagen or keratocyte function.