Table 1_Clinical features and management of medication-induced persistent corneal epithelial defects due to topical ophthalmic medications.docx

Treatment efficacy was evaluated using slit-lamp examination and in vivo confocal microscopy (IVCM).</p>Results<p>The clinical manifestation of MI-PCED initiated with epithelial roughness and dry eye symptoms, ultimately progressing to persistent epithelial defects and corneal ulcers. The severity of epithelial decompensation correlated significantly with the number of concurrent medications (P < 0.05), administration frequency (P < 0.001), and medication duration (P < 0.05).

Pharmacovigilance evaluation classified 80.0% of cases as “Probable” adverse drug reactions, with 58.3% graded as moderate (Grade 2) and 41.7% as severe (Grade 3). Following 7–30 days of targeted regenerative therapy, the cure rates were 88.57% for Grade I, 90.91% for Grade II, 77.78% for Grade III, and 80.00% for Grade IV. The overall cure rate was 86.67%.</p>Conclusions<p>The severity of MI-PCED is heavily dependent on the type, subacute duration, and frequency of topical ophthalmic drug use.

Management requires a flexible, step-wise strategy focused on restoring ocular surface homeostasis. This includes withdrawing toxic agents, preserving tear film stability with preservative-free tears, and strategically utilizing BCL and AMT to provide mechanical protection and biological support for severe epithelial decompensation.</p>