When we forget the essentials: about an unexpected corneal complication of cataract surgery

Session Details

Session Title: Moderated Poster Session: Focus on Multifocal IOLs and Cataract Surgery
Session Date/Time: Friday 21/02/2020 | 14:00-15:00
Paper Time: 14:48
Venue: Poster Area


First Author: C.Khodriss MOROCCO
Co Author(s): I. El Jazouli  S. El Maaroufi  A. Bennis  F. Chraibi  M. Abdellaoui  I. Ben Attya Andaloussi  

Abstract Details

Purpose:

To describe the importance of checking medical history of patient undergoing to a cataract surgery. We report a case of a peripheral ulcerative keratitis (PUK) after cataract surgery in a patient who had chronic arthritis treated by anti-inflammatory drugs without a clear diagnosis.

Setting:

The patient was treated ophtalmology department Hassan II hospital, Sidi Mohammed Ben Abdellah University FEZ MOROCCO

Methods:

Single interventional case report. An elderly man report a chronic arthritis under auto medication. No check-up was prescribed. A successful phacoemulsification was performed in the left eye, and a topical non-steroidal anti-inflammatory drug was prescribed. At the routine visit one week after surgery, a painless peripheral ulcer concentric to the limbus in the infer- temporal quadrant of the left eye was noted. The visual acuity was 08/10, no scleritis or anterior chamber inflammation, or suppuration were associated. The anterior segment optical coherence tomography (AS-OCT) demonstrates area of significant ulceration and thinning measured at 330microns.

Results:

The patient received a topical steroid therapy and preservative-free artificial tears. The topical non-steroidal anti-inflammatory drug was stopped. A monitoring with slit lamp examination and AS-OCT was established. On review at week 10, the PUK had completely resolved. A systemic evaluation and a rheumatology consult uncovered active rheumatoid arthritis. The patient was placed on oral prednisone and an immunosuppressive treatment is discussed.

Conclusions:

This case illustrates that peripheral ulcerative keratitis may occur after a cataract surgery and may be the presenting sign of a previously undiagnosed rheumatoid disease. A detailed questioner review of medical history of patient undergoing cataract surgery must be systematic, because perioperative immunosuppression and a careful use of topical non-steroidal anti-inflammatory can minimize the chance of PUK developing in such cases.

Financial Disclosure:

... receives non-monetary benefits from a company producing, developing or supplying the product or procedure presented