Posters

Neurotrophic ulcer complicated by stromal melting

Poster Details

First Author: D.Jaafari MOROCCO

Co Author(s): S. Belghmidi   S. Boutagayout   M. Cheqraoui   I. Hajji   A. Elmoutaouakil        

Abstract Details

Purpose:

We report the case of a monophthalmic patient, followed for dry eyes. She was pseudophakic patient who presented, after a cataract surgery, a neurotrophic ulcer complicated by stromal melting.

Setting:

CHU Mohamed VI, Marrakech, Morocco

Methods:

Mrs. F., 68 years old, monophthalmic of her left eye (old trauma of her right eye).She was followed for a dry syndrome with a negative etiological report, and operated for cataract of the left eye (manual extracapsular extraction), whose postoperative results  were marked by the occurrence of a neurotrophic ulcer put under artificial tears with a good improvement. Missed for 6 months, the patient presented to the emergency department for a painful red eye with a decrease in visual acuity.

Results:

The patient had a visual acuity in her left eye at "count the fingers closely", conjunctival hyperemia, a stromal melting with a 360 ° neovascularization, a collapsed anterior chamber and an externalized PMMA implant in both sides, nasal and temporal. The patient had benefited from a multi-layer amniotic membrane graft and a tarsorraphy with the prospect of an urgent transfixant keratoplasty. Missed for one month, the patient presented to the emergency department for a burst of the left eye with a visual acuity at no perception of light.  Then the patient was programmed for evisceration of the left eye.

Conclusions:

The management of neurotrophic corneal ulcer is difficult. The clinical approach must include accurate interrogation and systematic clinical examination; during it the evaluation of the size and the depth as well as the sensitivity is important. Therapeutic management must be rapid, adapted and sequential, because the visual function, more of that, the integrity of the globe are most often threatened, as well as the general prognosis.

Financial Disclosure:

None