Background. We report a patient who developed corneal epithelial disorder repeatedly after changing the prescription from Xalatan eye drops (Pfizer Inc.) to Latanoprost eye drops (Kaken Pharmaceutical Co., Ltd.), both containing 0.005% latanoprost. Case Report. An 88-year-old male with glaucoma had been treated with Timoptol eye drops and Xalatan eye drops for a few years. While he stayed in a health care facility for the elderly, Xalatan eye drops was changed to Latanoprost eye drops usage, and eye pain developed on the day of this change. On the next day, he visited our department, and corneal epithelial disorder was observed. The drops were discontinued, and the corneal epithelial disorder healed after 2 days. Twenty days after the first consultation, Xalatan eye drops and Latanoprost eye drops were resumed by a physician of internal medicine in the health care facility, but eye pain developed again. After discontinuation of the two drugs, Xalatan eye drops usage was resumed the next day, but no corneal epithelial disorder was observed thereafter. Conclusions. This clinical history strongly suggested the association between a generic drug, Latanoprost eye drops, and the development of corneal epithelial disorder.

KeywordsIn-the-bag intraocular lens · Dislocation of an intralocular lens · Repeating increase in intraocular pressure and normalization · In situ scleral refixation AbstractWe observed repeated episodes of rapid increases in intraocular pressure (IOP) considered to be caused by an in-the-bag intraocular lens (IOL) instability in a patient with an implanted IOL. As acute glaucoma attack-like increase in IOP was noted in the left eye on November 8, she was admitted to Wakayama Medical University Hospital. The findings at the first examination included an IOP of 62 mm Hg, instability of a PMMA one-piece IOL, shallow anterior chamber, narrow angle, moderate mydriasis, and loss of pupillary light reaction in the left avitreous eye. On November 15, a 6-mm Hg increase in IOP was observed during 60-min dark room prone provocative testing. After the first examination, the patient perceived pain and reduced visual acuity of the left eye and emergently consulted our hospital twice. Despite miosis, normalization of the anterior chamber depth and IOP with widening of the angle were achieved by resting in the supine position. These episodes were thought to be caused by instability and anterior shift of the IOL. On January 17, 2018, suture fixation of the in-the-bag IOL was performed. The IOL was fixed by transscleral suturing of the bilateral supporting parts to the sclera. Recurrence of sudden ophthalmalgia, instability of the in-the-bag IOL, and an increase in IOP have not been observed for 1 year after surgical treatment. Instability of an in-the-bag IOL caused Case

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Background: Corneal infection of Colletotrichum gloeosporioides is uncommon and usually limited to the anterior stroma. However, we observed a case of corneal stromal perforation caused by this fungus under a compromised condition. Case: A 73-year-old woman consulted us with a severe corneal ulceration. She was a tangerine orange farmer who suffered from rheumatoid arthritis for more than ten years. Before consultation with us, she received pterygium excision in her right eye. She then developed a corneal ulceration and received topical glucocorticoid therapy upon diagnosis of rheumatoid arthritis-related stromal ulcer in the eye. At the first consultation with us, a corneal ulceration was observed in the inferotemporal area of her right cornea. Biological examination detected a filamentous fungus, Colletotrichum gloeosporioides. Topical and systemic antifungal treatments were not significantly effective. Fourteen days after consultation, the lesion grew worse, leading to stromal perforation, which was treated by therapeutic penetrating keratoplasty using a preserved corneal button. Conclusions: Topical glucocorticoid could accelerate the growth of Colletotrichum gloeosporioides before diagnosis, even though the primary cause of corneal ulceration development might be rheumatoid arthritis.

PURPOSE: We examined intraocular pressure (IOP)-reducing effects 12 months after switching timolol maleate/travoprost combination ophthalmic solution in one bottle (TM/TR-COMBI-SOL) to carteolol hydrochloride/latanoprost combination ophthalmic solution in one bottle (CR/LT-COMBI-SOL). CASES: The participants included 25 patients (25 eyes) who could be followed up for 12 months after a switch from TM/TR-COMBI-SOL to CR/LT-COMBI-SOL in Saiseikai Arida Hospital between March 1, 2017, and August 31, 2018. They consisted of patients in whom antiglaucoma eye drop other than TM/TR-COMBI-SOL had not been used (monotherapy group, 12 patients [12 eyes], 12.8 ± 3.0 mmHg) and those in whom antiglaucoma eye drop other than TM/TR-COMBI-SOL had been concomitantly used (multitherapy group, 13 patients [13 eyes], 13.8 ± 2.4 mmHg). We excluded patients in whom drugs for glaucoma were changed or added during the follow-up and those who underwent intraocular surgery. MATERIALS AND METHODS: We retrospectively and statistically examined the IOP before eye drop switching and after 1, 6, and 12 months, using the paired t -test. RESULTS: The IOPs 1 month after eye drop switching in the monotherapy group and multitherapy group were 12.5 ± 3.3 and 13.8 ± 2.5 mmHg, respectively. The values after 6 months were 13.5 ± 3.0 and 11.5 ± 2.7 mmHg, respectively. Those after 12 months were 12.8 ± 2.7 and 11.7 ± 2.5 mmHg, respectively. In the monotherapy group, there was no significant difference during the follow-up period. In the multitherapy group, there were significant decreases in comparison with the preswitching value after 6 and 12 months ( P < 0.05, respectively). CONCLUSION: The IOP-reducing effects of CR/LT-COMBI-SOL were similar to those of TM/TR-COMBI-SOL. However, the effects may be enhanced after switching from TM/TR-COMBI-SOL in patients receiving multitherapy.