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K. F. Tabbara; Treatment of Atypical Bacterial Keratitis With Moxifloxacin 1.0% Eyedrops. Invest. Ophthalmol. Vis. Sci. 2007;48(13):762.
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Atypical bacterial keratitis may follow Laser in-situ keratomileusis (LASIK) and contact lens wear. Early diagnosis and prompt treatment can lead to rapid recovery and good visual outcome. The main purpose of this study was to evaluate the effects of Moxifloxacin 1.0% eyedrops in the treatment of atypical bacterial keratitis.
A total of six patients with keratitis caused by atypical bacteria were included. Each patient underwent complete ophthalmologic examination and microbiologic evaluation. Corneal scraping specimens were subjected to Grams, Giemsa and acid-fast stains and cultures. Patients were started on moxifloxacin 1.0% eyedrops every hour for a period of three days and was tapered to every two hours, thereafter, for a period of two weeks. Each patient was evaluated daily for a period of three days and weekly thereafter, until complete healing of the cornea. Healing of the ulcer was documented by decrease in corneal infiltration and edema, decrease in corneal ulceration with reepithelialization of the cornea.
There were a total of six patients with unilateral indolent corneal ulcers. Four cases developed keratitis following LASIK and two patients were contact lens wearers. Three had Mycobacteria chelonae and three had Nocardia asteroides. Two cases with Nocardia asteroides keratitiswere contact lens wearers. The time of initiation of treatment was 7-20 days following the onset of the disease. All six patients showed healing of the corneal ulcers, decrease in corneal infiltration and improvement in visual acuity over a period of 4-8 weeks. Two patients developed dense central corneal scar that required penetrating keratoplasty. All patients had a final visual acuity after treatment of 20/40 or better.
Moxifloxacin 1.0% eyedrops appear to be safe and effective in the treatment of indolent keratitis caused by Nocardia asteroides and Mycobacteria chelonae. Early diagnosis and prompt treatment provides rapid recovery and good outcome.
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