advertisement
Abstract #23582 Published in IGR 11-2
Peripheral ulcerative keratitis after trabeculectomy in a patient with rheumatoid arthritis
Papaconstantinou D; Georgopoulos G; Kalantzis G; Krassas A; Georgalas ICornea 2009; 28: 111-113
PURPOSE: To report the unusual occurrence of peripheral ulcerative keratitis, 10 days after trabeculectomy in a 35-year-old patient with rheumatoid arthritis (RA). METHODS: Observational case report. RESULTS: A 35-year-old patient with RA and secondary Sjogren disease underwent an uneventful fornix-based trabeculectomy. Ten days after surgery, slit-lamp examination revealed a peripheral corneal ulcer extending from 5- to 7-o'clock positions with a surrounding inflammatory infiltrate and adjacent conjunctival injection. The ulcer was treated with systemic and topical steroids, antibiotic eyedrops, artificial tears, and a bandage soft contact lens. Since then, corneal re-epithelialization started and the patient's symptoms subsided. The ulcer improved steadily within 2 months while the patient used a soft contact lens. The ulcer did not reoccur in the 18 months follow-up while the patient remained under systemic treatment. CONCLUSION: This report highlights the importance of careful examination and close postoperative follow-up in patients with RA undergoing any intraocular surgery, to diagnose a possible development of peripheral ulcerative keratitis. Although the incidence is rare, prompt diagnosis of the peripheral ulceration is essential because if untreated it may seriously affect patient's vision.
D. Papaconstantinou. Department of Ophthalmology, G Gennimatas Hospital, University of Athens, Athens, Greece.
Classification:
12.8.11 Complications, endophthalmitis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
