Minoxidil-induced alteration of corneal topography after radial keratotomy

[Minoxidil-induced ophthalmic hypertension (case report)]

This article presents a case of a 31-year-old male patient who presented to the outpatient department of the Krasnov Research Institute of Eye Diseases with complaints of diplopia and increased intraocular pressure (IOP) up to 30 mm Hg. The patient had been using minoxidil topically for androgenic alopecia for 8 years. On examination, mild swelling of the bulbar conjunctiva in the upper fornix was revealed; optical coherence tomography showed thinning of the ganglion cell layer, most likely due to moderate myopia. The patient responded well to discontinuation of minoxidil and topical therapy with prostaglandin analogues. After 4 months, an attempt was made to replace topical hypotensive therapy with carbonic anhydrase inhibitors, but the previous hypotensive regimen had to be resumed due to an increase in IOP. During 10 months of observation, no signs of progression were detected according to optical coherence tomography and static perimetry.

Topical Minoxidil Solution-Induced Central Toxic Keratopathy following Photorefractive Keratectomy: A Case Study

Purpose

To report the clinical findings of unilateral central toxic keratopathy (CTK) associated with inadvertent exposure to topical minoxidil 5% solution 1 day after bilateral photorefractive keratectomy (PRK).

Methods

Anterior segment slit-lamp photography, anterior segment optical coherence tomography (AS-OCT), pachymetry map, epithelial map, and manifest refractions were recorded.

Results

This is a case of a 27-year-old male who underwent bilateral PRK and presented 5 days after surgery with the complaint of acute decreased visual acuity in the left eye (LE). His LE was reportedly exposed to topical ethanol-based minoxidil 5% on postoperative day 1, which he was using as a posthair transplant treatment. Clinical examination showed hyperopic shift, poor visual acuity, central corneal opacity, epithelial irregularity, central corneal thinning, and flattening on AS-OCT. These findings were consistent with a diagnosis of CTK. The patient was monitored with conservative treatment and demonstrated full recovery after 6 months.

Conclusion

It is recommended to warn patients who have undergone refractive surgery concerning the use of ethanol-containing agents, such as minoxidil solution, because of the possible risk of CTK, a complication not formally recognized.