Of increasing concern, however, are reports of growing resistance of normal ocular flora to commonly employed antibiotic classes including macrolides, aminoglycosides, and 3rd generation fluoroquinolones.3-5 The recent availability of 4th generation fluoroquinolones: gatifloxacin 0.3% (Zymar, Allergan Pharmaceuticals, Irvine, Calif) and moxifloxacin 0.5% (Vigamox, Alcon Fort Worth, TX) has notably enhanced our armamentarium and are widely used due to their greater potency. Not surprisingly however, recent reports have begun to surface documenting emerging resistance to these 4th generation fluoroquinolones as well.6,7