Fluoroquinolone antibacterial eye drops: effects on normal human corneal epithelium, stroma, and endothelium

Ryou Watanabe, Toru Nakazawa, Shunji Yokokura, Akira Kubota, Hisayo Kubota, Kohji Nishida
Department of Ophthalmology, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan

Background: In vitro studies have suggested the corneal cytotoxicity of third-generation fluoroquinolone levofloxacin (LVFX) and fourth-generation fluoroquinolone moxifloxacin hydrochloride (MFLX) among fluoroquinolone antibacterial eye drops. This study investigated the effects of these two eye drops on the human cornea in vivo.
Methods: We evaluated 30 healthy adults (19 men and 11 women, 38.3 ± 6.3 years old). Each subject received an LVFX ophthalmic solution 0.5% in one eye and an MFLX ophthalmic solution 0.5% in the other eye three times daily for 7 days. Functional and morphological corneal changes before and after instillation were evaluated through ophthalmic examinations including breakup time of tear film (BUT) as measured by fluorescein staining and DR-1, Schirmer I test, Heidelberg Retina Tomograph II Rostock Cornea Module (HRTII-RCM), specular microscope, and Pentacum examination.
Results: Both the LVFX and MFLX groups had no significant change in each examination before and after instillation. There was also no statistically significant difference in measurements after the 7-day instillation between the groups.
Conclusion: Our study results suggest that as with LVFX, MFLX used in a normal clinical setting is unlikely to cause any obvious adverse effects on human normal cornea.

Keywords: cornea, fluoroquinolones, ocular surface, toxicity

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