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. 2017 Dec;7(1):15.
doi: 10.1186/s12348-017-0133-4. Epub 2017 Jun 12.

Neomycin, polymyxin B, and dexamethasone allergic reactions following periocular surgery

Nicholas A Moore  1 , Craig N Czyz  2   3 , Tracy D Carter  2 , Jill A Foster  4 , Kenneth V Cahill  4
Affiliations

Neomycin, polymyxin B, and dexamethasone allergic reactions following periocular surgery

Nicholas A Moore et al. J Ophthalmic Inflamm Infect. 2017 Dec.

Abstract

Background: The aim of this study was to evaluate the rate of periocular allergic skin reactions to topical neomycin, polymyxin B, and dexamethasone (NPD) ophthalmic ointment.

Methods: A consecutive patient prospective study was performed. A total of 522 patients who had a procedure involving incision of the periocular skin with subsequent postoperative application of NPD ophthalmic ointment were included. Patients were evaluated for signs of allergy at 1 week postoperatively or prior if the patient had complaints. A periocular allergic reaction was defined as any periocular skin pruritus, erythema, edematous papules, vesicles, or plaques at the site of ointment application beyond that of the typical postprocedure presentation. The patients continued to be monitored for 30 days postoperatively.

Results: Of the 522 patients who completed the study, eight (1.5%) had a definitive periocular allergic contact dermatitis to the NPD ophthalmic ointment. Allergic presentation ranged from postoperative day 3 to 14.

Conclusions: The rate of periocular allergic reactions to NPD ophthalmic ointment is significantly lower than reported in the literature for other topical preparations of neomycin and polymyxin B. The low rate of allergy in this study suggests that NPD ophthalmic ointment can safely be applied to the periocular skin with a very minimal risk of inciting an allergic reaction.

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Figures

Fig. 1
Fig. 1
Patient on postoperative day 7 following left ectropion repair. The patient displays an allergic reaction to the NPD ointment that he applied two to three times a day to the upper and lower eyelid on the left
Fig. 2
Fig. 2
Patient on postoperative day 7 following bilateral lower eyelid entropion repair. This patient illustrates an allergic reaction to the NPD ointment that she applied two to three times a day. This particular patient was also instructed to apply ointment onto the ocular surface for dryness causing a conjunctival reaction to the NPD that can be seen in the form of conjunctival edema and hyperemia
See this image and copyright information in PMC

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