ABSTRACT
A 24-year-old woman with a 5-year history of bilateral keratoconus who was in her eighth month of pregnancy presented with central corneal edema and mild acute iritis in her right eye. The iritis responded rapidly to therapy with topical corticosteroids, which was stopped after 1 week. The patient returned 1 week later with a markedly edematous central cornea, which had perforated. Management included a therapeutic soft contact lens, patching and, eventually, penetrating keratoplasty. The authors discuss the possible role of the pregnancy and of the topical corticosteroids in the development of the corneal perforation, a rare complication of keratoconus.
Subject(s)
Corneal Diseases/etiology , Keratoconus/complications , Adult , Female , Humans , Rupture, SpontaneousABSTRACT
Twenty-eight eyes were followed prospectively by goniophotography after cataract surgery. Ten had no intraocular lens (IOL), ten had the "Azar 91Z" lens implanted and eight had the Cilco "Optiflex" lens inserted. Iris-haptic synechia or burial occurred in 9 of 10 of the "91Z" group and three of eight of the "Optiflex" lenses. These changes developed predominantly in the inferior angle and were seen as soon as 4 weeks postoperatively. Based on this data, preoperative gonioscopy is recommended prior to removal of these IOLs. Cutting buried haptics and leaving them within iris stroma may be a safe surgical alternative which avoids undue trauma to the anterior segment.
