Toxic Keratopathy Secondary to Topical Proparacaine
| Autor: | Anıl Kubaloğlu, Esin Söğütlü Sarı, Pınar Sorgun Evcili, Sibel Akyol, Arif Koytak,, Yusuf Özertürk |
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| Jazyk: | English<br />Turkish |
| Rok vydání: | 2012 |
| Předmět: | |
| Zdroj: | Türk Oftalmoloji Dergisi, Vol 42, Iss 1, Pp 30-34 (2012) |
| Druh dokumentu: | article |
| ISSN: | 1300-0659 2147-2661 82599947 |
| DOI: | 10.4274/tjo.42.246330 |
| Popis: | Pur po se: To evaluate the clinical findings of toxic keratopathies secondary to topical proparacaine (Alcaine, Alcon) abuse and the results of medical and/or surgical treatment options. Ma te ri al and Met hod: We retrospectively analyzed twenty-two eyes of 25 patients who developed toxic keratopathy secondary to topical anesthetic abuse between March 2005 and December 2009. Severe pain unresponsive to medical treatment with persistent epithelial defects (PED) and stromal ulcers were managed with amniotic membrane transplantation (AMT). Some cases have undergone optical penetrating keratoplasty (PK). Clinical findings and complications were assessed, and visual acuities were measured before and after treatment. At the sixthmonth follow-up visit, endothelial cell densities (ECD) were determined with specular microscopy in both affected and unaffected eyes for statistical comparison. Re sults: The mean time interval between the initiation of topical anesthetic use and admission to our clinic was 2.26 months. Epithelial defects, circular stromal keratitis and corneal edema were present in all eyes. Epithelial defects were healed with medical treatment in 15 eyes (60%). AMT was performed in 10 eyes, following a mean of 26.1 days after initiation of medical treatment. Visual acuity before the treatment was 0.1 or below in all eyes. At the last control visit including 3 eyes having had PK, best-corrected visual acuities were 0.5 or better in 13 eyes (52%), between 0.2 and 0.4 in 7 eyes (28%) and 0.1 or worse in 5 eyes (20%). No statistically significant difference was found between ECD of affected and unaffected eyes of 13 patients in whom specular microscopy was possible. Dis cus si on: Topical anesthetic abuse may cause severe toxic keratopathy and lead to significant visual loss related to stromal opacities despite intensive treatment. AMT was found effective and successful in healing PED and stromal ulcers as well as in breaking the vicious circle of anesthetic abuse with the relief of pain. (Turk J Ophthalmol 2012; 42: 30-4) |
| Databáze: | Directory of Open Access Journals |
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