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Nepafenac-associated bilateral corneal melt after photorefractive keratectomy
Vahid Feiz1, Thomas J Oberg, Christopher J Kurz
1Department of Ophthalmology and Vision Science, University of California-Davis, Davis, CA, USA.
Purpose:
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.
