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Cross-sectionalAmerican journal of ophthalmology · 2026

Corneal Epithelial Alterations Associated With Cyclin-Dependent Kinase 4/6 Inhibitor Therapy in Hormone Receptor-Positive Breast Cancer.

Esra Kızıldag Ozbay, Banu Ozturk, Mehmet Fatih Ozbay … Mustafa Karaca

OphthalmologyCross-sectional

Corneal surface damage far more common with CDK4/6 inhibitor therapy

Corneal Epithelial Alterations Associated With Cyclin-Dependent Kinase 4/6 Inhibitor Therapy in Hormone Receptor-Positive Breast Cancer.

Esra Kızıldag Ozbay … Mustafa Karaca

American journal of ophthalmology · 2026

Background

IMPORTANCE: Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors are standard therapy for hormone receptor-positive (HR+), HER2-negative breast cancer.

Purpose

To determine whether CDK4/6 inhibitor-based therapy is associated with cornealepithelial alterations independent of aromatase inhibitor exposure and tear film dysfunction.

Methods

DESIGN, SETTING, AND PARTICIPANTS: Retrospective comparative cross-sectional study at a tertiary ophthalmology center.

n = 132 women

Results

eye surface got scratched, damaged more often on this cancer drug

44.4%

CDKAI

4.7%

AI

2.3%

Controls

More results

All moderate (13.3%) and severe/complicated (8.9%) PE cases occurred exclusively in the CDKAI group.

Vortex keratopathy was observed in 13.3% of CDKAI patients and in none of the other groups (P = .025).

Schirmer values, tear film break-up time, and Ocular Surface Disease Index scores did not differ among groups (all P > .05).

More results

Within the CDKAI group, PE was not associated with treatment duration (P = .963) or tear film parameters.

“

Conclusion · 1 of 3

In this comparative study, CDK4/6 inhibitor-based therapy was associated with significantly higher prevalence and severity of PE and vortex keratopathy, independent of aromatase inhibitor exposure and in the absence of measurable tear film dysfunction.

Conclusion · 2 of 3

These findings suggest a direct cytostatic effect on the corneal epithelium. Symptom scores were low, although Ocular Surface Disease Index interpretation was limited by incomplete responses.

Conclusion · 3 of 3

Proactive corneal surface evaluation with fluorescein staining may be warranted during CDK4/6 inhibitor treatment.

Post

Corneal Epithelial Alterations Associated With Cyclin-Dependent Kinase 4/6 Inhibitor Therapy in Hormone Receptor-Positive Breast Cancer.

Corneal surface damage far more common with CDK4/6 inhibitor therapy

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