Intraocular safety of ciprofloxacin
S. X. Stevens, B. D. Fouraker and H. G. Jensen
Henry Ford Hospital, Department of Ophthalmology, Detroit, Mich.
Retinal toxicity resulting from the treatment of exogenous bacterial
endophthalmitis with multiple antibiotics has increased the importance of
evaluating the efficacy of new potent antibiotics for monotherapy. The
retinal and corneal toxicity of ciprofloxacin hydrochloride, which is
rapidly bactericidal against gram-positive and gram-negative bacteria, was
evaluated in the rabbit eye. Retinal toxicity was dose-dependent in phakic
and aphakic rabbit eyes as determined with electroretinography, light
microscopy, and transmission electron microscopy. An intravitreal dose of
greater than 100 micrograms also resulted in dose-dependent acute corneal
toxicity in aphakic vitrectomized rabbit eyes. Results of instillation of
ciprofloxacin directly into the anterior chamber of phakic rabbit eyes
confirmed dose-dependent corneal toxicity. No retinal or corneal damage was
observed in aphakic or phakic rabbit eyes after administration of an
intravitreal dose of 100 micrograms. Results of electroretinography and
light microscopy alone are insufficient to evaluate the retinal toxicity of
antibiotics. Ultrasonic pachymetry is the best method of detecting probable
associated corneal toxicity.
