Honeycomb ensemble of corneal epithelium

Netarsudil-induced corneal honeycombing in childhood glaucomas

Netarsudil is a hypotensive drug that reduces intraocular pressure (IOP). Although it is used to treat corneal decompensation/edema in normotensive eyes, we observed the occurrence of corneal epithelial edema with corneal honeycombing in children with uncontrolled IOP (primary or secondary glaucoma) on maximal topical medication following netarsudil (0.02%) therapy of >2 weeks. Of 16 eyes of 16 children, 9 (56%) developed corneal honeycombing. They were younger than those without honeycombing (median age, 3.1 vs 9.7 years [P = 0.016]), had higher baseline IOP (35.6 ± 7.4 vs 27.2 ± 5.6 mm Hg [P < 0.001]), and usually had preexisting corneal edema (7/9 eyes vs none [P < 0.001]).