Nepafenac-associated bilateral corneal melt after photorefractive keratectomy.
OBJECTIVE
We are reporting a case of bilateral corneal melt after photorefractive keratectomy requiring bilateral corneal transplantations.


RESULTS
A 35-year-old man underwent uncomplicated photorefractive keratectomy and was treated postoperatively with topical nepafenac, one drop in both eyes every 2 hours. Three days into this course of treatment, the patient developed bilateral irritation and the dose was decreased to one drop every 4 hours. The next day, he developed stromal melting in both eyes. Although nepafenac was discontinued at this point, the ulcerative keratolysis progressed in both eyes requiring penetrating keratoplasty.


CONCLUSIONS
We report a case of sterile ulceration after photorefractive keratectomy surgery, which we believe was caused by frequent postoperative dosing of nepafenac.
Feiz
Vahid
V
Department of Ophthalmology and Vision Science, University of California-Davis, Davis, CA, USA.
Oberg
Thomas J
TJ
Kurz
Christopher J
CJ
Mamalis
Nick
N
Moshirfar
Majid
M
D000287:Administration, Topical; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000009:adverse effects*; D044482:Benzeneacetamides / Q000008:administration & dosage* / Q000009:adverse effects*; D003319:Corneal Stroma; D003320:Corneal Ulcer / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D004334:Drug Administration Schedule; D006801:Humans; D015948:Keratoplasty, Penetrating; D008297:Male; D010648:Phenylacetates / Q000008:administration & dosage* / Q000009:adverse effects*; D018903:Photorefractive Keratectomy; D011182:Postoperative Care; D012086:Reoperation
D000894:Anti-Inflammatory Agents, Non-Steroidal; D044482:Benzeneacetamides; D010648:Phenylacetates; C414203:nepafenac