Corneal Melt Associated With Cancer Immunotherapy

Purpose: The purpose of this study was to describe cases of corneal melt associated with systemic cancer immunotherapy. Methods: This is a case series of 6 patients. Results: Corneal melt was noted in all eyes, including 1 patient on an epidermal growth factor receptor (EGFR) inhibitor and another on a human epidermal growth factor 2 (HER2) inhibitor that resolved on serum tears; 1 patient on a fibroblast growth factor receptor (FGFR) inhibitor that stabilized on serum tears and amniotic membrane; 1 patient on a Bruton tyrosine kinase (BTK) inhibitor and another on a breakpoint cluster region protein-abelson murine leukemia viral oncogene homolog 1 (BCR-ABL) inhibitor that both had corneal thinning with perforation; and 1 patient with bilateral corneal thinning complicated by a fungal superinfection after long-term use of a programmed cell death protein 1 (PD-1) inhibitor. Conclusions: While primarily described with EGFR inhibitors, corneal melt may present with vision-threatening consequences in other classes of cancer immunotherapy including FGFR inhibitors, PD-1 inhibitors, and other tyrosine kinase inhibitors.