Cornea, Cataract and Refractive Surgery Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India.
Cornea, Cataract and Refractive Surgery Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India
BMJ Case Rep. 2022 Jul 11;15(7):e249400. doi: 10.1136/bcr-2022-249400.
A man in his 30s, with a history of two operated penetrating keratoplasty (PK), primarily for viral keratitis, presented with pain, redness and diminution of vision in his left eye of 4 days duration. Postoperatively, he was prescribed oral antivirals, topical steroid eyedrops, lubricants and antiglaucoma medications. Eight months after transplantation, an epithelial defect with heaped up margins was noted on anterior segment evaluation on a routine follow-up visit. On checking his medications, it was found that the patient was unknowingly using bromfenac drops in place of brimonidine tartrate for the past month. A diagnosis of neurotrophic keratitis was made in the setting of PK performed for viral keratitis, incited by use of topical bromfenac. The patient was prescribed preservative-free lubricants with immediate discontinuation of bromfenac drops. Topical steroid drops were withheld till the epithelial defect healed. Complete healing of the defect was noted after 4 weeks of therapy.
一位 30 多岁的男性，曾因病毒性角膜炎进行过两次穿透性角膜移植（PK）手术，此次因左眼疼痛、发红和视力下降 4 天就诊。手术后，他被开具了口服抗病毒药物、局部皮质类固醇眼药水、润滑剂和降眼压药物。移植术后 8 个月，在常规随访时的眼前节评估中发现上皮缺损，边缘堆积。检查他的药物时发现，过去一个月患者一直不知情地使用溴芬酸钠滴眼液代替马来酸噻吗洛尔滴眼液。在因病毒性角膜炎而进行的 PK 手术后，出现了神经退行性角膜病变的诊断，这是由局部使用溴芬酸钠引起的。患者被开了不含防腐剂的润滑剂，并立即停止使用溴芬酸钠滴眼液。在上皮缺损愈合之前，暂停使用皮质类固醇眼药水。经过 4 周的治疗后，缺损完全愈合。
