Riboflavin/UVA should be avoided in eyes with prior herpes simplex but otherwise posed no obvious safety risk in this series and appeared to be most effective when the infection depth was limited. The success rate was higher for bacterial infections than fungal infections. Randomized studies against antibiotics alone are needed to further evaluate efficacy.
Topical IFNalpha2b alone may be an effective treatment of primary CIN. It appears to be a safe alternative to radiation, intralesional IFNalpha2b injection, and surgical excision with cryotherapy. Larger population studies with longer follow-up are recommended to better assess the risk of recurrence and other possible adverse effects.
We describe a patient with systemic graft-versus-host disease who developed a nonhealing epithelial defect after cataract surgery that healed on cessation of a topical nonsteroidal antiinflammatory drug (NSAID) (ketorolac). The patient developed a central corneal perforation in the fellow eye while on a new NSAID formulation (nepafenac) after routine cataract surgery. Our case suggests that new topical NSAIDs may be similar to older NSAID formulations in promoting corneal melting in patients predisposed to poor epithelialization and corneal wound healing.
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