Purpose: To report on severe visual impairment in a patient with decreased tear secretion in whom dense corneal deposits resulted from tosufloxacin treatment after cataract surgery.
Methods: An 86-year-old woman complained of blurred vision in the left eye. She had been treated with topical applications of tosufloxacin, betamethasone, and diclofenac sodium, all administered 4 times a day as a regimen lasting for 1 month after cataract surgery. In that eye, the best spectacle-corrected visual acuity was 20/200 due to the dense deposits on the cornea. The Schirmer test showed a decrease in basic tear secretion (right eye 2 mm, left eye 1 mm). We removed these deposits surgically and analyzed them by infrared spectrophotometry.
Results: The best spectacle-corrected visual acuity markedly improved, to 20/25, after surgical removal of the deposits in the left eye. The spectrophotometric pattern of the deposits was consistent with that of tosufloxacin.
Conclusions: Topical application of tosufloxacin may lead to fluoroquinolone drug deposition on the cornea, especially when an antibiotic drug has been used continuously in patients with poor tear secretion.