Severe unilateral corneal melting after uneventful phacoemulsification cataract surgery.

Abstract

We present a rare case of severe unilateral corneal melt after uneventful phacoemulsification. A 38-year-old woman presented one week after uneventful phacoemulsification cataract surgery complaining of pain and blurred vision in her operated eye. Our differential diagnosis included peripheral ulcerative keratitis, Mooren's ulcer and herpetic keratitis. The patient was started on oral acyclovir and topical steroids. An extensive blood work-up was done to rule out autoimmune diseases. Purified protein derivative test demonstrated 15 mm of erythema. Because the clinical picture was progressing, the patient was started on triple anti-tuberculosis therapy. Despite treatment, the patient was complaining of excruciating eye pain that was relieved only with intramuscular prednisone injections. The corneal melt healed after approximately three months without any other intervention, leaving a 90 per cent thickness loss in its central area. Idiopathic corneal melt after uneventful phacoemulsification is a rare complication, which must be managed in a multidirectional treatment approach to prevent devastating corneal perforation.

• Authors: Anna Praidou, Periklis Brazitikos, Anna Dastiridou, Sofia Androudi
• Journal: Clinical & experimental optometry (Clin Exp Optom) Vol. 96 Issue 1 Pg. 109-11 (Jan 2013) ISSN: 1444-0938 [Electronic] United States
• PMID: 22686354 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2012 The Authors. Clinical and Experimental Optometry © 2012 Optometrists Association Australia.

Chemical References

• Glucocorticoids
• Prednisone

Topics

• Adult
• Autoimmune Diseases (diagnosis, drug therapy, etiology)
• Cornea (pathology)
• Diagnosis, Differential
• Female
• Glucocorticoids (administration & dosage)
• Humans
• Phacoemulsification (adverse effects)
• Postoperative Complications
• Prednisone (administration & dosage)
• Visual Acuity