Abstract
BACKGROUND: Corneal epithelial downgrowth is an uncommon, yet potentially sight-threatening complication of intraocular surgery or trauma with poor prognosis. We hereby describe a case of epithelial downgrowth after penetrating keratoplasty which was treated by intracameral 5-fluorouracil injection. CASE DESCRIPTION: In 2019, penetrating keratoplasty was performed for a 69-year-old man with pseudophakic bullous keratopathy. Six months after penetrating keratoplasty, an endothelial opacity suspicious of epithelial downgrowth was noted. Two treatments of intracameral 5-fluorouracil injection were performed at the eighth and ninth month after penetrating keratoplasty, which allowed the epithelial downgrowth to become quiescent. A repeated penetrating keratoplasty with intracameral application of mitomycin C was subsequently performed without reactivation of the epithelial downgrowth. CONCLUSION: Intracameral 5-fluorouracil injection is effective in halting disease progression in epithelial downgrowth.