A case of late spontaneous post-radial keratotomy corneal perforation managed with specialty lenses
| Autor: | Kim B.M. Boven, Lieselotte Anthonissen, Jonas J.I. Van den Heurck, Carina Koppen, Maarten Van Hoey |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Visual acuity Time Factors genetic structures Contact Lenses medicine.medical_treatment Prosthesis Design law.invention Cornea 03 medical and health sciences 0302 clinical medicine Scleral lens law Ophthalmology medicine Myopia Humans Keratotomy Radial Rupture Spontaneous Wound dehiscence business.industry Corneal Perforation Corneal perforation Middle Aged medicine.disease eye diseases Sclera Lens (optics) Radial keratotomy medicine.anatomical_structure 030221 ophthalmology & optometry Female sense organs Human medicine medicine.symptom business 030217 neurology & neurosurgery Bandage Tomography Optical Coherence Follow-Up Studies |
| Zdroj: | Eye & contact lens: science and clinical practice |
| ISSN: | 1542-2321 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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