Presumed Corneal Ulcer Following Topical Use of Diclofenac Sodium in One Eyed Patient with Keratoplasty
DOI:
https://doi.org/10.12974/2309-6136.2014.02.01.1Keywords:
Diclofenac sodium, Corneal ulcer, Keratoplasty, Amniotic membrane.Abstract
Purpose: To report a case with corneal ulcer after keratoplasty connected to long-term use of topical 0.1% diclofenac sodium. Methods: A 81-year-old man presented with corneal ulceration. The patient’s clinical history showed that he had keratoplasy after ocular trauma for about 10 years ago. He was using topical dexamethasone sodium phosphate 0.1% and topical diclofenac sodium 0.1% for one year. Diclofenac sodium and dexamethasone sodium phosphate were discontinued, and amniotic membrane transplantation and bandage contact lens application were performed. Results: After the amniotic membrane transplantation; at the first month, melting area disappeared, increase in corneal transparency and improvement in visual acuity was recorded. Conclusion: Use of long-term diclofenac sodium may be responsible for the corneal ulceration in our patient, and we suggest that amniotic membrane transplantation may be a good choice in similar cases.
References
Lin JC, Rapuano CJ, Laibson PR, et al. Corneal melting associated with use of topical nonsteroidal anti-inflammatory drugs after ocular surgery. Arch Ophthalmol 2000; 118: 1129–1132. http://dx.doi.org/10.1016/S0886-3350(01)00801-X
Congdon NG, Schein OD, von Kulajta P, et al. Corneal complications associated with topical ophthalmic use of nonsteroidal anti inflammatory drug. J Cataract Refract Surg 2001; 27: 622–631.
Flach AJ. Corneal melts associated with topically applied nonsteroidal anti-inflammatory drugs. Trans Am Ophthalmol Soc 2001; 99: 205–212.
Guidera AC, Luchs JI, Udell IJ. Keratitis, ulceration, and perforation associated with topical nonsteroidal antiinflammatory drugs. Ophthalmology 2001; 108: 936–944. http://dx.doi.org/10.1016/S0161-6420(00)00538-8
Mian SI, Gupta A, Pineda R2nd. Corneal ulceration and perforation with ketorolac tromethamine (Acular®) use after PRK. Cornea 2006; 25: 232–234. http://dx.doi.org/10.1097/01.ico.0000179931.05275.dd
Asai T, Nakagami T, Mochizuki Met al. Three cases of corneal melting after instillation of a new nonsteroidal antiinflammatory drug. Cornea 2006; 25: 224–227. http://dx.doi.org/10.1097/01.ico.0000177835.93130.d4
Shimazaki J, Saito H, Yang HY, Toda I, Fujishima H, Tsubota K. Persistent epithelial defect following penetrating keratoplasty: an adverse effect of diclofenac eye drops. Cornea 1995; 14(6): 623-7. http://dx.doi.org/10.1097/00003226-199511000-00018
Demirel S, Sarac O. Late corneal perforation with topical diclofenac sodium use after radiotherapy. Eye Contact Lens 2012; 38: 197-9. http://dx.doi.org/10.1097/ICL.0b013e318235c4ed
Prasher P. Acute corneal melt associated with topical bromfenac use. Eye Contact Lens 2012; 38: 260-2. http://dx.doi.org/10.1097/ICL.0b013e318235c506
O'Brien TP, Li OJ, Sauerburger F, et al. The role of matrix metalloproteinases in ulcerative keratolysis associated with perioperative diclofenac use. Ophthalmology 2001; 108: 656–659. http://dx.doi.org/10.1016/S0161-6420(00)00590-X
Isawi H, Dhalival DK. Corneal melting and perforation in Stevens Johnson syndrome following topical bromfenac use. J Cataract Refract Surg 2007; 33(9):1644-6. http://dx.doi.org/10.1016/j.jcrs.2007.04.041
