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June 2001

The Beneficial Effect of Diclofenac Sodium in the Treatment of Filamentary Keratitis

Arch Ophthalmol. 2001;119(6):926-927. doi:

Current treatment of filamentary keratitis (FK)—the presence of fine filaments composed of epithelial cells and mucus attached to the cornea—includes lubrication, acetylcysteine, therapeutic contact lenses,1 and mechanical removal of the filaments. Although these methods are usually effective, the condition can be resistant to treatment and can even cause complications such as corneal vascularization. We have had success with 0.1% diclofenac sodium drops, a nonsteroidal, anti-inflammatory compound, in the treatment of 6 patients with FK. The 6 prospective patients, who gave written informed consent to participate in the study, ranged in age from 40 years to 76 years (mean, 61 years). The FK was associated with dry eye in 5 patients and with corneal edema in 1. Four of them developed filaments several months after intraocular surgery: 2 after corneal transplantation, 1 after cataract surgery, and 1 after posterior vitrectomy combined with cataract surgery. Three patients received the drug as the first and only treatment; for the other 3 it was added to treatments they had been receiving for 2 to 12 months without success, including various lubricants, topical steroids, acetylcysteine, hypertonic solutions, mechanical removal of filaments, and therapeutic contact lenses. The 0.1% diclofenac sodium was applied topically 4 times a day for 3 to 4 weeks. Within 1 to 2 weeks of initial treatment, the filaments had disappeared from the corneas of all 6 patients. During the 8 months of follow-up, there were no recurrences of filaments and no adverse reactions to the drug.

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