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Peer-reviewedCC BY-NC-ND 4.0American Journal of Ophthalmology Case Reports

Bilateral interstitial keratitis following intracameral Durysta® (bimatoprost)

  • Michelle A. Spratt1
  • Millen S. Khangura1
  • Lauren Langman1
  • Andre Galenchik-Chan1
  • Timothy Chou2
  • Robert Honkanen2
  1. 1Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, United States
  2. 2Department of Ophthalmology, Stony Brook University, Stony Brook, NY, United States
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Abstract

Purpose: To report a case of bilateral interstitial keratitis following repeat intracameral bimatoprost injections.

Observations: A 92-year-old female with advanced primary open-angle glaucoma (POAG) and poor adherence to topical glaucoma medications received bilateral intracameral Durysta® (bimatoprost) implants twelve months apart. Four months following the second intracameral injections, she developed bilateral interstitial keratitis (IK) as evidenced by keratitic precipitates and deep corneal stromal vascularization on slit lamp examination. There was no history of prior herpetic keratitis or blepharoconjunctivitis, and syphilis testing was negative. The patient was treated with valacyclovir and prednisolone acetate, with subsequent slow improvement in her corneal findings.

Conclusions and importance: This case highlights a rare adverse event following repeated intracameral bimatoprost implants. We speculate that the IK was triggered by herpes simplex virus (HSV) reactivation from the repeated bimatoprost injections although other etiologies including a delayed hypersensitivity reaction to the implant cannot be ruled out. Physicians should weigh the benefits of improved intraocular pressure control against the potential infectious or non-infectious inflammatory risks this agent possesses for individual patients.

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Cite

BibTeXRIS
BibTeX
@article{spratt2026bilateral,
  title = {{Bilateral interstitial keratitis following intracameral Durysta® (bimatoprost)}},
  author = {Michelle A. Spratt and Millen S. Khangura and Lauren Langman and Andre Galenchik-Chan and Timothy Chou and Robert Honkanen},
  journal = {American Journal of Ophthalmology Case Reports},
  year = {2026},
  month = oct,
  doi = {10.1016/j.ajoc.2026.102683},
  url = {https://doi.org/10.1016/j.ajoc.2026.102683},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Bilateral interstitial keratitis following intracameral Durysta® (bimatoprost)
AU  - Michelle A. Spratt
AU  - Millen S. Khangura
AU  - Lauren Langman
AU  - Andre Galenchik-Chan
AU  - Timothy Chou
AU  - Robert Honkanen
PY  - 2026
DA  - 2026/10/17
JO  - American Journal of Ophthalmology Case Reports
DO  - 10.1016/j.ajoc.2026.102683
UR  - https://doi.org/10.1016/j.ajoc.2026.102683
AB  - Purpose: To report a case of bilateral interstitial keratitis following repeat intracameral bimatoprost injections.  Observations: A 92-year-old female with advanced primary open-angle glaucoma (POAG) and poor adherence to topical glaucoma medications received bilateral intracameral Durysta® (bimatoprost) implants twelve months apart. Four months following the second intracameral injections, she developed bilateral interstitial keratitis (IK) as evidenced by keratitic precipitates and deep corneal stromal vascularization on slit lamp examination. There was no history of prior herpetic keratitis or blepharoconjunctivitis, and syphilis testing was negative. The patient was treated with valacyclovir and prednisolone acetate, with subsequent slow improvement in her corneal findings.  Conclusions and importance: This case highlights a rare adverse event following repeated intracameral bimatoprost implants. We speculate that the IK was triggered by herpes simplex virus (HSV) reactivation from the repeated bimatoprost injections although other etiologies including a delayed hypersensitivity reaction to the implant cannot be ruled out. Physicians should weigh the benefits of improved intraocular pressure control against the potential infectious or non-infectious inflammatory risks this agent possesses for individual patients.
SN  - 2451-9936
ER  -