Failure of intracameral fluorouracil to resolve an epithelial ingrowth following clear corneal cataract surgery

We present a case of epithelial ingrowth that progressed despite repeated intracameral injections of fluorouracil (5-FU). Six months after cataract surgery, a retrocorneal membrane was found advancing from the corneal section. At 1 year, 0.5 mg of 5-FU in 0.1 mL of balanced salt solution was exchanged for 0.1 mL of aqueous. Ingrowth initially stopped, but progressed 6 months later. Two further injections of 0.5 mg of 5-FU were given at 1-month intervals, followed by 1 mg of 5-FU 3 and 6 months later. Each injection initially halted progression of the ingrowth, but then it recurred. Ultimately, the treatment failed to prevent progression of the disease and angle-closure glaucoma ensued. Resolution of epithelial ingrowth with intracameral 5-FU has been reported twice. We found no reports of such treatment following clear corneal cataract surgery or with eventual epithelial ingrowth progression. Epithelial ingrowth remains a relentless and challenging condition to treat.