Corneal epithelial dysplasia after trifluridine use

Graefes Arch Clin Exp Ophthalmol. 1983;220(1):6-12. doi: 10.1007/BF02307009.


Prolonged topical trifluridine treatment of herpes simplex keratitis in three elderly patients produced slightly raised dysplastic corneal epithelial lesions. The involved epithelium had a ground-glass appearance and exhibited opaque cells, edema, and spindle-shaped surface cells. Histopathology demonstrated severe cellular atypism, loss of cell polarity, dyskeratosis, parakeratosis, and a few mitotic figures. The pathological change was apparently intraepithelial. After scraping, the edema and opaque cells in the regenerated epithelium gradually disappeared in 3-4 months on cessation of trifluridine therapy. In one patient recurrence of dendritic keratitis, 5 weeks after scraping, was treated by topical bromovinyldeoxyuridine eye drops. Since severe epithelial dysplasia may represent a precancerous condition, prolonged use of trifluridine should be avoided.

Publication types

  • Case Reports

MeSH terms

  • Age Factors
  • Aged
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / adverse effects*
  • Bromodeoxyuridine / administration & dosage
  • Bromodeoxyuridine / analogs & derivatives
  • Cornea / drug effects
  • Cornea / pathology
  • Corneal Diseases / chemically induced*
  • Epithelium / drug effects
  • Epithelium / pathology
  • Humans
  • Keratitis, Dendritic / drug therapy
  • Male
  • Microscopy, Phase-Contrast
  • Thymidine / analogs & derivatives*
  • Trifluridine / administration & dosage
  • Trifluridine / adverse effects*
  • Trifluridine / therapeutic use


  • Antiviral Agents
  • brivudine
  • Bromodeoxyuridine
  • Trifluridine
  • Thymidine