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Title
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A case of late spontaneous post-radial keratotomy corneal perforation managed with specialty lenses
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Author
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Abstract
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| Purpose: To describe a case of spontaneous wound dehiscence 29 years after radial keratotomy (RK) and to illustrate how specialty contact lenses were used for tectonic support and optic correction. Setting: Tertiary referral center for corneal pathology. Design: Case report. Results: In November 2014, a 62-year-old woman presented to the emergency department with a spontaneous corneal perforation in her left eye. Her ocular history was significant only for uncomplicated RK surgery performed in 1985 to correct myopia (-5.50 D) in both eyes. At the slit-lamp pronounced, bullous edema was seen in the inferotemporal quadrant of the left cornea with internal opening of the 3.30- and 5-o'clock positions incisions and severe localized thinning and aqueous leakage at the 5-o'clock position incision. There was no history of trauma. A conservative approach was adopted: application of a standard bandage lens was effective in tamponading the leakage, allowing the anterior chamber to reform; a custom-made soft lens was worn for tectonic support over a period of 4 months. Finally, visual acuity was restored to 20/20-by fitting a scleral lens. Conclusion: Spontaneous corneal perforation is a rare but more dramatic long-term complication after RK. The pivotal role of appropriately fitted soft bandage lenses in the conservative management of this type of complex perforation is highlighted. For optical correction, a scleral lens was fitted with excellent visual result, illustrating the added value of specialty contact lenses as an alternative to surgery in the management of postrefractive corneas. |
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Language
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English
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Source (journal)
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Eye & contact lens: science and clinical practice
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Publication
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2018
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ISSN
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1542-2321
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DOI
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10.1097/ICL.0000000000000353
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Volume/pages
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44
:s:[1]
(2018)
, p. S341-S344
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ISI
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000457837000063
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Pubmed ID
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30157159
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Full text (Publisher's DOI)
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Full text (publisher's version - intranet only)
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