RESUMO
PURPOSE: To report persisting corneal erosion and trichomegaly as ocular side effects of cetuximab (Erbitux) treatment, a monoclonal antibody against the epidermal growth factor (EGF) receptor. METHODS: A 62-year-old patient was treated with combined chemotherapy including cetuximab for colorectal carcinoma and showed accelerated growth of eyelashes with persistent bilateral corneal erosions resistant to conservative treatment. Topical EGF was successfully applied as an experimental treatment to antagonize the inhibitory effect of the EGF receptor antibody. RESULTS: Topical application of EGF led to rapid improvement, with complete healing of the epithelial defect after 7 (left eye) and 19 days (right eye) while application of cetuximab was continued. CONCLUSIONS: Cetuximab (Erbitux) can cause impairment of corneal wound healing as an ocular side effect. Patients concerned may benefit from application of EGF eyedrops.
Assuntos
Anticorpos Monoclonais/efeitos adversos , Antineoplásicos/efeitos adversos , Doenças da Córnea/induzido quimicamente , Receptores ErbB/imunologia , Pestanas/efeitos dos fármacos , Hipertricose/induzido quimicamente , Administração Tópica , Anticorpos Monoclonais Humanizados , Cetuximab , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/patologia , Doenças da Córnea/diagnóstico , Doenças da Córnea/tratamento farmacológico , Fator de Crescimento Epidérmico/uso terapêutico , Pestanas/patologia , Humanos , Hipertricose/diagnóstico , Hipertricose/tratamento farmacológico , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/secundário , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/secundário , Masculino , Pessoa de Meia-Idade , Proteínas Recombinantes/uso terapêutico , Neoplasias Esplênicas/tratamento farmacológico , Neoplasias Esplênicas/secundário , Cicatrização/efeitos dos fármacosRESUMO
PURPOSE: To compare the time necessary for complete epithelial healing after penetrating keratoplasty carried out for various corneal dystrophies. METHODS: In a retrospective single-center study, 679 eyes that underwent nonmechanical keratoplasty were evaluated concerning postoperative epithelial healing time. On the basis of corneal pathology, the eyes were divided into 5 groups: group 1, lattice dystrophy (n = 9); group 2, macular dystrophy (n = 16); group 3, Fuchs dystrophy (n = 207); group 4, granular dystrophy (n = 13); group 5, keratoconus (n = 434). After keratoplasty, the time necessary for complete healing of the epithelial defect was compared among the groups. RESULTS: In lattice dystrophy, 22% showed delayed healing, in contrast to 0% in granular dystrophy. Mean time necessary for healing in group 1 (8.8 +/- 9.4 days) was significantly longer than in group 2 (2.5 +/- 2.5 days, P = 0.003), group 3 (4.4 +/- 4.1 days, P = 0.09), group 4 (2.2 +/- 1.4 days, P = 0.003), and group 5 (3.1 +/- 2.7 days, P = 0.005). CONCLUSIONS: In patients with lattice dystrophy, delayed epithelial healing after penetrating keratoplasty may be anticipated. Patients should be counseled accordingly.
