Case Report

Toxic Anterior Segment Syndrome with Intracameral Moxifloxacin: Case Report and Review of the Literature

Table 1

Case reports of toxicity associated with intracameral moxifloxacin.

PublicationSubjectIndication for intracameral moxifloxacinMoxifloxacin brandMoxifloxacin doseOther intra-op medicationsAdverse effects (AEs)Time to onset of AEsPostoperative medications started prior to onset of AEs

Light and Falkenberry 20191 of 1Endophthalmitis prophylaxis for PPV for symptomatic floatersVigamox0.1 ml of 5 mg/mlNoneDecreased VA, AC flare, pigment dispersion in AC and angle, iris depigmentation, iris TID, elevated IOPPost-op week 3Unspecified topical steroid, NSAID, fluoroquinolone
Peñaranda-Henao et al. 20201 of 1Endophthalmitis prophylaxis for cataract surgeryUnknownUnknownUnknownOcular pain, headache, elevated IOP, AC inflammation with keratic precipitates, pigment dispersion in the AC and angle, pupil deformation with poor reactivity, iris atrophy and TID, pigmented cells in the anterior vitreous, mild decrease in foveal brightnessPost-op week 2.5Oral acyclovir, intramuscular betamethasone, topical prednisolone acetate, topical timolol. Later, acyclovir was switched to valacyclovir
Sanchez-Sanchez et al. 20201 of 4Endophthalmitis prophylaxis for express shunt implantation for POAGVigamox0.1 ml of 5 mg/mlSubconjunctival mitomycin C 0.2 mg/mlPigment dispersion in the AC, filtering bleb, and angle around the express shunt, mild mydriasis with sluggish light reactionPost-op week 4Topical moxifloxacin, diclofenac sodium, predinoslone acetate
Sanchez-Sanchez et al. 20202 of 4Endophthalmitis prophylaxis for express shunt implantation for POAGVigamox0.1 ml of 5 mg/mlSubconjunctival mitomycin C 0.2 mg/mlPigment dispersion in the AC and filtering bleb, fixed middilated pupilPost-op week 2Topical moxifloxacin, diclofenac sodium, predinoslone acetate
Sanchez-Sanchez et al. 20203 of 4Endophthalmitis prophylaxis for deep non-penetrating sclerotomies with supraciliary hema implant for glaucomaVigamox0.1 ml of 5 mg/mlSubconjunctival mitomycin C 0.2 mg/mlPigment dispersion in AC and on endothelium, mydriasis with poor light reaction, iris TID, elevated IOP at post op month 3 secondary to pigment obstruction of the trabeculo-Descemet membranePost-op week 4Topical moxifloxacin, diclofenac sodium, predinoslone acetate
Sanchez-Sanchez et al. 20204 of 4Endophthalmitis prophylaxis for deep non-penetrating sclerotomies with supraciliary hema implant for POAGVigamox0.1 ml of 5 mg/mlSubconjunctival mitomycin C 0.2 mg/mlPigment dispersion under bleb, TID, irregular pupilPost-op week 6Topical moxifloxacin, diclofenac sodium, predinoslone acetate
Zubicoa et al. 20201 of 1Endophthalmitis prophylaxis for cataract surgeryVigamox0.1 ml of 5 mg/mlUnknownEye pain, circumciliary congestion, pigment deposition on the IOL and in the angle, flare, mydriasis, iris TIDPost-op week 3.5Unspecified topical steroid

AC: anterior chamber; AEs: adverse effects; IOP: intraocular pressure; NSAID: nonsteroidal anti-inflammatory; PPV: pars plana vitrectomy; POAG: primary open angle glaucoma; TID: transillumination defect; VA: visual acuity.