Irreversible corneal decompensation in patients treated with topical dorzolamide

PURPOSE: To describe irreversible corneal decompensation after topical dorz olamide hydrochloride (Trusopt; Merck and Co, Inc, West Point, Pennsylvania ) therapy in nine patients who had histories consistent with corneal endoth elial compromise. METHOD: Multicenter review of patients' charts. RESULTS: Nine eyes of nine patients developed overt corneal decompensation after starting topical dorzolamide, a condition that did not resolve with d rug cessation. This occurred after 3 to 20 weeks (mean, 7.8) of therapy, Al l nine patients had undergone intraocular surgery. Eight patients had under gone cataract surgery; three were aphakic and three had posterior chamber i ntraocular lenses. Two patients had anterior chamber intraocular lenses and also had undergone trabeculectomies. Four patients had undergone penetrati ng keratoplasties, each case complicated by episodes of corneal allograft r ejection that were successfully treated. Two patients had asymptomatic Fuch s endothelial dystrophy, Seven patients have since undergone successful pen etrating keratoplasties. CONCLUSION: The reports suggest that dorzolamide can cause irreversible cor neal edema in a subset of glaucoma patients with endothelial compromise, Th e findings suggest a rationale for research into the longterm effects of do rzolamide on the corneal endothelium. (Am J Ophthalmol 1999;127:403-406. (C ) 1999 by Elsevier Science Inc. All rights reserved.).