Tineke N. Decaestecker

Confirmation of ofloxacin precipitation in corneal deposits by microbore liquid chromatography-quadrupole time-of-flight tandem mass spectrometry

We investigated the corneal precipitate of a 6-year-old boy with vernal keratoconjunctivitis (VKC), treated with topical ofloxacin 0.3% eyedrops. Because of the extremely small sample amount (corneal scraping), a very sensitive and specific method was needed with the possibility of an unambiguous identification of ofloxacin, supposed to be present in the precipitate. In this respect, tandem Q-TOF mass spectrometry combined with micro LC (1 mm I.D.) was chosen. Confirmation of the presence of ofloxacin in the deposit was obtained by means of the characteristic product ion spectrum produced by CID. This clearly indicated that the precipitate, removed by corneal scraping from the 6-year-old boy with VKC, contained ofloxacin.

Corneal deposits after the topical use of ofloxacin in two children with vernal keratoconjunctivitis

Topical fluoroquinolones are broad spectrum, bactericidal agents with activity against both Gram positive and Gram negative corneal pathogens. Single drug administration with topical fluoroquinolones has been effectively used in treatment of bacterial ulcerative keratitis. The drugs are safe, but a white crystalline deposit, that in most cases spontaneously dissolved, has been reported1–4 with ciprofloxacin 0.3% and norfloxacin 0.3%. Up to now this side effect has not been described with ofloxacin 0.3%. We present two children with severe vernal conjunctivitis who developed corneal deposits after use of ofloxacin 0.3% eye drops. ### Patient 1 A 6 year old boy with vernal keratoconjunctivitis (VKC) developed a painful right eye while on holiday. His ophthalmologist diagnosed a corneal ulcer and prescribed ofloxacin eye drops followed by ofloxacin ointment four times a day for 3 weeks, associated with prednisolone drops. As the inflammation in the right eye persisted, the child was referred to our department. Slit lamp examination revealed mild VKC and a corneal ulcer with a …