Maudgal P C, Van Damme B, Missotten L
Graefes Arch Clin Exp Ophthalmol. 1983;220(1):6-12. doi: 10.1007/BF02307009.
Prolonged topical trifluridine treatment of herpes simplex keratitis in three elderly patients produced slightly raised dysplastic corneal epithelial lesions. The involved epithelium had a ground-glass appearance and exhibited opaque cells, edema, and spindle-shaped surface cells. Histopathology demonstrated severe cellular atypism, loss of cell polarity, dyskeratosis, parakeratosis, and a few mitotic figures. The pathological change was apparently intraepithelial. After scraping, the edema and opaque cells in the regenerated epithelium gradually disappeared in 3-4 months on cessation of trifluridine therapy. In one patient recurrence of dendritic keratitis, 5 weeks after scraping, was treated by topical bromovinyldeoxyuridine eye drops. Since severe epithelial dysplasia may represent a precancerous condition, prolonged use of trifluridine should be avoided.
三名老年单纯疱疹性角膜炎患者长期局部使用三氟尿苷治疗后，出现了轻度隆起的发育异常角膜上皮病变。受累上皮呈毛玻璃样外观，可见不透明细胞、水肿及梭形表面细胞。组织病理学显示严重细胞异型性、细胞极性丧失、角化不良、不全角化及少量有丝分裂象。病理改变明显位于上皮内。刮除后，停用三氟尿苷治疗3 - 4个月，再生上皮中的水肿和不透明细胞逐渐消失。一名患者在刮除后5周出现树枝状角膜炎复发，采用局部溴乙烯脱氧尿苷滴眼液治疗。由于严重的上皮发育异常可能代表一种癌前状态，应避免长期使用三氟尿苷。
