Document Detail


Corneal complications associated with topical ophthalmic use of nonsteroidal antiinflammatory drugs.
MedLine Citation:
PMID:  11311634     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To explore the potential association between adverse corneal events and the use of topical nonsteroidal antiinflammatory drugs (NSAIDs). SETTING: Practice-based reports. METHODS: A detailed case-reporting form and request for medical records were sent to all practices reporting cases of corneal or conjunctival pathology in association with the use of topical NSAIDs to the American Society of Cataract and Refractive Surgery. Cases were classified as "mild," "moderate," or "severe" according to predetermined clinical criteria. RESULTS: Records of 140 eyes (129 patients) were reviewed; 51 cases (36.4%) were mild, 55 (39.3%) moderate, and 34 (24.3%) severe. An association with a specific topical NSAID was confirmed in 117 cases (81.8%). Most confirmed cases (53.8%) involved generic diclofenac (Falcon). Cases associated with brand diclofenac (Voltaren, CIBA Vision) and ketorolac (Acular, Allergan) were more likely to have ocular comorbidity and to have received significantly higher total doses of NSAIDs. Neither "off-label" use nor use of any specific agent was associated with severe compared to mild or moderate disease. However, patients with more severe adverse events were more likely to have a history of diabetes, previous surgery in the affected eye, and surgery other than cataract. Cases not occurring in the perioperative period had significantly worse outcomes, had significantly more ocular comorbidities, and received nearly 3 times the dose of NSAIDs. CONCLUSIONS: While topical NSAIDs as a class may be associated with severe adverse events, such events appeared to require potentiation in the form of high total doses, ocular comorbidities, or both with Acular and Voltaren. Severe adverse events might have been more likely to occur at lower doses and in routine postoperative settings with generic diclofenac.
Authors:
N G Congdon; O D Schein; P von Kulajta; L H Lubomski; D Gilbert; J Katz
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of cataract and refractive surgery     Volume:  27     ISSN:  0886-3350     ISO Abbreviation:  J Cataract Refract Surg     Publication Date:  2001 Apr 
Date Detail:
Created Date:  2001-04-20     Completed Date:  2001-06-07     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8604171     Medline TA:  J Cataract Refract Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  622-31     Citation Subset:  IM    
Affiliation:
The Wilmer Eye Institute, Dana Center for Preventive Ophthalmology, Baltimore, MD, USA.
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MeSH Terms
Descriptor/Qualifier:
Administration, Topical
Aged
Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
Cornea / drug effects*
Corneal Diseases / chemically induced*
Female
Humans
Male
Ophthalmic Solutions / adverse effects
Grant Support
ID/Acronym/Agency:
K23 EY00388/EY/NEI NIH HHS; K24 EY00395/EY/NEI NIH HHS
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 0/Ophthalmic Solutions

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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