Corneal perforation after conductive keratoplasty with previous refractive surgery

J Cataract Refract Surg. 2003 Dec;29(12):2452-4. doi: 10.1016/s0886-3350(03)00347-x.

Abstract

A 56-year-old woman had conductive keratoplasty (CK) for residual hyperopia and astigmatism. Three years before the procedure, the patient had arcuate keratotomy, followed by laser in situ keratomileusis 2 years later for high astigmatism correction in both eyes. During CK, a corneal perforation occurred in the right eye; during the postoperative examination, an iris perforation and anterior subcapsule opacification were seen beneath the perforation site. The perforation was managed with a bandage contact lens and an antibiotic-steroid ointment; it had a negative Seidel sign by the third day. The surgery in the left eye was uneventful. Three months after the procedure, the uncorrected visual acuity was 20/32 and the best corrected visual acuity 20/20 in both eyes with a significant improvement in corneal topography. Care must be taken to prevent CK-treated spots from coinciding with areas in the corneal stroma that might have been altered by previous refractive procedures.

Publication types

  • Case Reports

MeSH terms

  • Anti-Infective Agents / therapeutic use
  • Astigmatism / surgery
  • Corneal Diseases / etiology*
  • Corneal Stroma / surgery*
  • Electrocoagulation / adverse effects*
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Hyperopia / surgery*
  • Iris Diseases / etiology
  • Keratomileusis, Laser In Situ*
  • Keratotomy, Radial*
  • Lens Capsule, Crystalline / pathology
  • Lens Diseases / etiology
  • Middle Aged
  • Occlusive Dressings
  • Radio Waves
  • Rupture, Spontaneous
  • Visual Acuity

Substances

  • Anti-Infective Agents
  • Glucocorticoids