Delayed corneal perforation secondary to topical diclofenac use after LASEK

To report a case of delayed corneal perforation secondary to topical diclofenac usage after myopic LASEK and review of literature. A 25-year-old female with history of myopic LASEK 2 months before referred to her surgeon with epithelial defect, stromal thinning and infiltration. She was treated with antimicrobial medications for infectious keratitis for one week. She was then referred to Labbafinejad Medical Center because of lack of response and progressive stromal thinning. Two days after admission, corneal perforation was occurred. Smear and culture of the cornea were negative. She had used topical diclofenac for 6 weeks. After discontinuing the topical medications and conservative measures [oral acetazolamide, patching, simple eye ointment] the perforation started healing. Prolonged use of topical non-steroidal anti-inflammatory drugs after surface ablation may lead to stromal melting and corneal perforation; therefore, such medications should be used cautiously in these patients especially in high risk groups such as rheumatoid arthritis, dry eye syndrome, ocular surface disorders and neurotrophic keratopathy

Primary graft failure and systemic presentations of HSV infection following transplantation of an HSV-contaminated donor cornea

To report a case of primary graft failure [PGF] and systemic manifestations of herpes simplex virus [HSV] infection following transplantation of an HSV-contaminated donor cornea. A 28-year-old male with history of penetrating keratoplasty 12 days before, developed intraocular inflammation with marked anterior chamber reaction, graft edema and elevated intraocular pressure [IOP] together with systemic manifestations such as fever and unilateral cervical adenopathy. Systemic manifestations resolved after a few days but the graft edema was persistent. Regraft was performed after 3 months and the previous donor tissue was evaluated by PCR for cytomegalovirus [CMV] and HSV and was positive for HSV. HSV may be a cause of PGF, which can be transmitted by a contaminated donor cornea to the recipient. This condition may also lead to systemic symptoms