ブロムフェナクナトリウム点眼が原因と疑われた角膜潰瘍の2例

Two cases of corneal ulcer following instillation of bromfenac sodium ophthalmic solution

要約　2眼の角膜潰瘍が，非ステロイド性抗炎症薬であるブロムフェナクナトリウム点眼後に生じた。1例は58歳男性で，水疱性角膜症に合併した強膜炎に対して本薬点眼と抗菌薬眼軟膏を点眼し，3日後に角膜中央部の実質深層に達する潰瘍が発症した。他の1例は71歳男性で，右翼状片の手術後に本薬点眼，抗菌薬点眼，ステロイド薬点眼を行い切除部が完全に上皮化したが，術後40日目に切除部の角膜輪部に潰瘍が生じた。両症例ともブロムフェナクナトリウム点眼を中止し，短期間で潰瘍が治癒した。ブロムフェナクナトリウムなどの非ステロイド性抗炎症薬点眼で，重篤な角膜障害が起こる可能性を示す症例であり，注意が望まれる。

Abstract.　Corneal ulcer developed in 2 eyes following instillation of bromfenac sodium ophthalmic solution,one of nonsteroidal antiinflammatory drugs. One case was a 58-year-old male. He had bullous keratopathy with scleritis. He received instillation of bromfenac and antifungal agent. Three days later,a deep stromal ulcer developed in the central cornea. The other was a 71-year-old male who underwent surgery for pterygium. The excised corneal area became epithelialized following instillation of bromfenac,antifungal agent,and corticosteroid. A corneal ulcer developed in the excised corneal area 40 days after surgery. Discontinuation of bromfenac was followed by prompt cure of corneal ulcer. These cases illustrate that severe corneal damage is a liability after topical use of nonsteroidal antiinflammatory drugs including bromfenac ophthalmic solution.