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Isotretinoin-related post-surgical interface alterations during sun light exposure: A case report
Sara Spelta1, Antonio Di Zazzo1,2,3, Mariateresa Laborante1
1Ophthalmology Campus Bio-Medico University, Rome, Italy.
European Journal of Ophthalmology
|April 29, 2025
Summary
Systemic isotretinoin therapy can cause ocular surface changes, potentially affecting outcomes after refractive surgery. Patients must disclose all medications, including acne treatments, before procedures like photorefractive keratectomy (PRK).
Area of Science:
- Ophthalmology
- Dermatology
Background:
- Refractive surgery (PRK, LASIK) is common, but patient history often omits systemic treatments.
- Isotretinoin, used for severe acne, is rarely linked to corneal abnormalities.
Observation:
- A 26-year-old female underwent PRK without disclosing isotretinoin use.
- Post-surgery, she developed bilateral basal membrane irregularities and subepithelial interface alterations.
Findings:
- Subepithelial haze persisted despite topical therapy changes but resolved over 2.5 months.
- Final uncorrected visual acuity was 20/20 in both eyes.
Implications:
- Isotretinoin can cause ocular surface changes (corneal, dry eye, conjunctival).
- UVB exposure during healing may worsen isotretinoin-induced corneal effects.
- Thorough patient anamnesis is crucial before refractive surgery; perioperative isotretinoin may be a relative contraindication.
