Journal of Cataract & Refractive Surgery
Volume 27, Issue 4 , Pages 622-631 , April 2001

Corneal complications associated with topical ophthalmic use of nonsteroidal antiinflammatory drugs

  • Nathan G Congdon, MD, MPH

      Affiliations

    • The Wilmer Eye Institute, Dana Center for Preventive Ophthalmology (Congdon, Schein, Lubomski, Gilbert, Katz), USA
    • None of the authors has a financial or proprietary interest in any product mentioned. Dr. Schein is a paid consultant to Alcon, Inc., on research related to dry eye.
    • ,
  • Oliver D Schein, MD, MPH

      Affiliations

    • The Wilmer Eye Institute, Dana Center for Preventive Ophthalmology (Congdon, Schein, Lubomski, Gilbert, Katz), USA
    • Cornea and Anterior Segment Service (Schein, von Kulajta), USA
    • None of the authors has a financial or proprietary interest in any product mentioned. Dr. Schein is a paid consultant to Alcon, Inc., on research related to dry eye.
    • Corresponding Author InformationReprint requests to Dr. Oliver D. Schein, 116 Wilmer Building, 600 North Wolfe Street, Baltimore, Maryland 21287, USA
    • ,
  • Petra von Kulajta, MD

      Affiliations

    • Cornea and Anterior Segment Service (Schein, von Kulajta), USA
    • None of the authors has a financial or proprietary interest in any product mentioned. Dr. Schein is a paid consultant to Alcon, Inc., on research related to dry eye.
    • ,
  • Lisa H Lubomski, PhD

      Affiliations

    • The Wilmer Eye Institute, Dana Center for Preventive Ophthalmology (Congdon, Schein, Lubomski, Gilbert, Katz), USA
    • None of the authors has a financial or proprietary interest in any product mentioned. Dr. Schein is a paid consultant to Alcon, Inc., on research related to dry eye.
    • ,
  • Donna Gilbert

      Affiliations

    • The Wilmer Eye Institute, Dana Center for Preventive Ophthalmology (Congdon, Schein, Lubomski, Gilbert, Katz), USA
    • None of the authors has a financial or proprietary interest in any product mentioned. Dr. Schein is a paid consultant to Alcon, Inc., on research related to dry eye.
    • ,
  • Joanne Katz (ScD)

      Affiliations

    • The Wilmer Eye Institute, Dana Center for Preventive Ophthalmology (Congdon, Schein, Lubomski, Gilbert, Katz), USA
    • Johns Hopkins University School of Hygiene and Public Health, Division of Disease Control (Congdon, Schein, von Kulajta, Lumbowski, Gilbert), Baltimore, Maryland, USA
    • None of the authors has a financial or proprietary interest in any product mentioned. Dr. Schein is a paid consultant to Alcon, Inc., on research related to dry eye.

,Accepted 8 February 2001.

References 

  1. Nichols J, Snyder RW. Topical nonsteroidal anti-inflammatory agents in ophthalmology. Curr Opin Ophthalmol. 1998;9(4):40–44
  2. Flach AJ, Jampol LM, Weinberg D, et al.  Improvement in visual acuity in chronic aphakic and pseudophakic cystoid macular edema after treatment with topical 0.5% ketorolac tromethamine. Am J Ophthalmol. 1991;112:514–519
  3. Italian Diclofenac Study Group . Efficacy of diclofenac eyedrops in preventing postoperative inflammation and long-term cystoid macular edema. J Cataract Refract Surg. 1997;23:1183–1189
  4. Weisz JM, Bressler NM, Bressler SB, Schachat AP. Ketorolac treatment of pseudophakic cystoid macular edema identified more than 24 months after cataract extraction. Ophthalmology. 1999;106:1656–1659
  5. Miyake K, Masuda K, Shirato S, et al.  Comparison of diclofenac and fluorometholone in preventing cystoid macular edema after small incision cataract surgery (a multicentered prospective trial). Jpn J Ophthalmol. 2000;44:58–67
  6. Tinkelman DG, Rupp G, Kaufman H, et al.  Double-masked, paired-comparison clinical study of ketorolac tromethamine 0.5% ophthalmic solution compared with placebo eyedrops in the treatment of seasonal allergic conjunctivitis. Surv Ophthalmol. 1993;38:133–140
  7. Tauber J, Raizman MB, Ostrov CS, et al.  A multicenter comparison of the ocular efficacy and safety of diclofenac 0.1% solution with that of ketorolac 0.5% solution in patients with acute seasonal allergic conjunctivitis. J Ocular Pharmacol Ther. 1998;14:137–145
  8. Stewart R, Grosserode R, Cheetham JK, Rosenthal A. Efficacy and safety profile of ketorolac 0.5% ophthalmic solution in the prevention of surgically induced miosis during cataract surgery. Clin Ther. 1999;21:723–732
  9. Frucht-Pery J, Siganos CS, Solomon A, et al.  Topical indomethacin solution versus dexamethasone solution for treatment of inflamed pterygium and pinguecula (a prospective randomized clinical study). Am J Ophthalmol. 1999;127:148–152
  10. Kaiser PK, Pineda R. A study of topical nonsteroidal anti-inflammatory drops and no pressure patching in the treatment of corneal abrasions. Ophthalmology. 1997;104:1353–1359
  11. Szucs PA, Nashed AH, Allegra JR, Eskin B. Safety and efficacy of diclofenac ophthalmic solution in the treatment of corneal abrasions. Ann Emerg Med. 2000;35:131–137
  12. Goethals M, Missotten L. Efficacy and safety of indomethacin 0.1% versus flurbiprofen 0.03% eyedrops in inflammation after argon laser trabeculoplasty. Doc Ophthalmol. 1994;85:287–293
  13. Flach AJ, Dolan BJ, Donahue ME, et al.  Comparative effects of ketorolac 0.5% or diclofenac 0.1% ophthalmic solutions on inflammation after cataract surgery. Ophthalmology. 1998;105:1775–1779
  14. Heier J, Cheetham JK, Degryse R, et al.  Ketorolac tromethamine 0.5% ophthalmic solution in the treatment of moderate to severe ocular inflammation after cataract surgery (a randomized, vehicle-controlled clinical trial). Am J Ophthalmol. 1999;127:253–259
  15. Simone JN, Pendelton RA, Jenkins JE. Comparison of the efficacy and safety of ketorolac tromethamine 0.5% and prednisolone acetate 1% after cataract surgery. J Cataract Refract Surg. 1999;25:699–704
  16. Kent AR, Dubiner HB, Whitaker R, et al.  The efficacy and safety of diclofenac 0.1% versus prednisolone acetate 1% following trabeculectomy with adjunctive mitomycin-C. Ophthalmic Surg Lasers. 1998;29:562–569
  17. Weinstock VM, Weinstock DJ, Weinstock SJ. Diclofenac and ketorolac in the treatment of pain after photorefractive keratectomy. J Refract Surg. 1996;12:792–794
  18. Rajpal RK, Cooperman BB. Analgesic efficacy and safety of ketorolac after photorefractive keratectomy. J Refract Surg. 1999;15:661–667
  19. Apt L, Voo I, Isenberg SJ. A randomized clinical trial of the nonsteroidal eyedrop diclofenac after strabismus surgery. Ophthalmology. 1998;105:1449–1452
  20. Sun R, Gimbel HV. Effects of topical ketorolac and diclofenac on normal corneal sensation. J Refract Surg. 1997;13:158–161
  21. Shimazaki J, Saito H, Yang H-Y, et al.  Persistent epithelial defects following penetrating keratoplasty (an adverse effect of diclofenac eyedrops). Cornea. 1995;14:623–627
  22. Gills JP. Voltaren associated with medication keratitis. (letter) J Cataract Refract Surg. 1994;20:110
  23. Sher NA, Krueger RR, Teal P, et al.  Role of topical corticosteroids and nonsteroidal antiinflammatory drugs in the etiology of stromal infiltrates after excimer photorefractive keratectomy. (letter) J Refract Corneal Surg. 1994;10:587–588
  24. Probst LE, Machat JJ. Corneal subepithelial infiltrates following photorefractive keratectomy. (letter) J Cataract Refract Surg. 1996;22:281
  25. 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
  26. Flach A. Topically applied nonsteroidal anti-inflammatory drugs and corneal problems (an interim review and comment). (editorial) Ophthalmology. 2000;107:1224–1226
  27. Hatchell DL, Magolan JJ, Besson MJ, et al.  Damage to the epithelial basement membrane in the corneas of diabetic rabbits. Arch Ophthalmol. 1983;101:469–471
  28. Herse PR. A review of manifestations of diabetes mellitus in the anterior eye and cornea. Am J Optom Physiol Opt. 1988;65:224–230
  29. Azar DT, Spurr-Michaud SJ, Tisdale AS, Gipson IK. Decreased penetration of anchoring fibrils into the diabetic stroma; a morphometric analysis. Arch Ophthalmol. 1989;107:1520–1523
  30. Azar DT, Spurr-Michaud SJ, Tisdale AS, Gipson IK. Altered epithelial-basement membrane interactions in diabetic corneas. Arch Ophthalmol. 1992;110:537–540
  31. Ljubimov AV, Huang ZS, Huang GH, et al.  Human corneal epithelial basement membrane and integrin alterations in diabetes and diabetic retinopathy. J Histochem Cytochem. 1998;46:1033–1041
  32. Tomas-Barberan S, Fagerholm P. Influence of topical treatment on epithelial wound healing and pain in the early postoperative period following photorefractive keratectomy. Acta Ophthalmol Scand. 1999;77:135–138
  33. Hersh PS, Rice BA, Baer JC, et al.  Topical nonsteroidal agents and corneal wound healing. Arch Ophthalmol. 1990;108:577–583
  34. Lu KL, Wee WR, Sakamoto T, McDonnell PJ. Comparison of in vitro antiproliferative effects of steroids and nonsteroidal antiinflammatory drugs on human keratocytes. Cornea. 1996;15:185–190

☆ Supported under a contractual agreement with the American Society of Cataract and Refractive Surgery; a K-23 Award (K-23 EY00388) from the National Eye Institute and a Career Development Award from Research to Prevent Blindness (Congdon); and a K-24 Award (K-24 EY00395) from the National Eye Institute and the Burton E. Grossman Fund for Preventive Ophthalmology (Schein).

PII: S0886-3350(01)00801-X

Journal of Cataract & Refractive Surgery
Volume 27, Issue 4 , Pages 622-631 , April 2001

Article Tools

* Image Usage & Resolution