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Full-Circle Cauterization of Limbal Vascular Plexus for Surgically Induced Glaucoma in Rodents
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Partial Stenosis and Complete Punctal Closure Following Topical Netarsudil Use for Glaucoma.

Ramy Rashad1, Catherine Zhu, Anna C Kupcha

  • 1Boston University School of Medicine/Boston Medical Center, Boston, MA.

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Summary

Topical netarsudil used for glaucoma treatment can cause punctal stenosis and closure. Discontinuing the medication often reverses these side effects, improving symptoms.

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Area of Science:

  • Ophthalmology
  • Pharmacology

Background:

  • Glaucoma management often involves topical medications.
  • Topical netarsudil is a Rho-kinase inhibitor used for lowering intraocular pressure.

Approach:

  • Retrospective case series of 10 patients using topical netarsudil.
  • Documented punctal disease (stenosis or closure) ipsilateral to treatment.
  • Literature review for similar reported cases.

Key Points:

  • Six patients developed partial punctal stenosis; four had complete punctal closure.
  • Punctal disease occurred only on the side treated with netarsudil.
  • Discontinuation of netarsudil led to reversal of punctal closure in 31-83 days.

Conclusions:

  • Topical netarsudil can cause iatrogenic punctal stenosis and closure.
  • These findings are critical for glaucoma treatment considerations.
  • Reversal of punctal disease is possible upon drug cessation.