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Related Experiment Video

Updated: Jul 10, 2026

Evaluating Therapeutic and Chemical Toxicity Using Organ-Cultured Porcine Corneas and Epithelial Wound Healing
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Nepafenac-associated corneal melt.

Eric Jay Wolf1, Lynda Z Kleiman, Amilia Schrier

  • 1Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA. ericwolfmd@yahoo.com

Journal of Cataract and Refractive Surgery
|October 30, 2007
PubMed
Summary

Topical nonsteroidal anti-inflammatory drugs (NSAIDs) may impede corneal healing after cataract surgery, particularly in patients with systemic graft-versus-host disease. Cessation of NSAIDs led to healing, suggesting a risk associated with these medications in vulnerable patients.

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Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Pharmacology

Background:

  • Systemic graft-versus-host disease (GVHD) can compromise ocular surface health and wound healing.
  • Cataract surgery is a common ophthalmic procedure requiring adequate corneal epithelialization for successful recovery.

Observation:

  • A patient with systemic GVHD experienced a nonhealing epithelial defect post-cataract surgery, which resolved after discontinuing ketorolac, a topical nonsteroidal anti-inflammatory drug (NSAID).
  • The fellow eye subsequently developed a central corneal perforation after cataract surgery while using a different topical NSAID formulation, nepafenac.

Findings:

  • Topical NSAIDs, including both older (ketorolac) and newer (nepafenac) formulations, may increase the risk of severe corneal complications.
  • Patients with pre-existing conditions affecting epithelialization, such as GVHD, appear particularly susceptible to NSAID-induced corneal melting.

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Implications:

  • Clinicians should exercise caution when prescribing topical NSAIDs to patients with compromised corneal healing potential, especially those with GVHD.
  • Further research is warranted to elucidate the specific mechanisms by which topical NSAIDs affect corneal wound healing in vulnerable populations.
  • Consideration should be given to alternative anti-inflammatory strategies or vigilant monitoring in patients at high risk for NSAID-related ocular surface toxicity.