Case of Corneal Melting Associated With the Use of Topical Nepafenac

Abstract

Topical nonsteroidal anti-inflammatory agents have been associated with corneal ulceration and stromal melts. This is, to our knowledge, the first reported case involving the new agent, Nepafenac.

Topical Bromfenac as an Adjunctive Treatment With Intravitreal Ranibizumab for Exudative Age-Related Macular Degeneration

“…On the contrary, a few adverse events of topical NSAIDs such as corneal melting were reported. 29,30 In the present study, we did not observe any adverse events related to the topical bromfenac; however, we should pay attention to any complication associated with the prolonged topical use of NSAIDs.…”

Nepafenac-associated Bilateral Corneal Melt After Photorefractive Keratectomy

“…11,14,15 Bekendam et al described a patient with multiple ocular problems, including chronic dry eye and Graves orbitopathy, who developed keratomalcia after using nepafenac 3 times a day for 2 weeks. The process rapidly resolved after discontinuation of the medication.…”

“…The process rapidly resolved after discontinuation of the medication. 15 Wolf et al described a patient with chronic graft versus host disease. This patient was on a combination of topical prednisolone 4 times a day and nepafenac 3 times a day.…”

Corneal melt in lattice corneal dystrophy type II after cataract surgery

“…Diclofenac sodium 0.1% is thought to induce aberrant (excessive or inappropriate) matrix metalloproteinase expression in the cornea, which is associated with corneal keratolysis. 25 Central corneal melting has recently been associated with the use of modern NSAIDs, especially nepafenac 26,27 and bromfenac, 28 after routine cataract surgery. However, no NSAID was prescribed for our patient.…”