A case of sight threatening complications from topical 1% 5-fluorouracil in the treatment of ocular surface squamous neoplasia

Abstract

Purpose: 1% topical 5-fluorouracil (5-FU) is a treatment for ocular surface squamous neoplasia (OSSN) due to its effectiveness, low cost, and tolerable side effect profile. To our knowledge there is no reported sight-threatening corneal complication of 1% 5-FU for the treatment of OSSN. Observations: We report a 78 year-old man with bilateral conjunctival intraepithelial neoplasia (CIN) who developed bilateral corneoscleral ulceration and corneal perforation of the left eye after 1% 5-FU topical treatment. Conclusions and Importance: Our case report describes serious potential complications of 1% 5-FU, reviews possible risk factors associated with poor outcomes, and discusses our treatment approach.

Keywords

• Cornea
• 5-Fluorouracil
• Ocular surface squamous neoplasia
• Conjunctival intraepithelial neoplasia
• Corneal ulceration
• Corneal perforation