[Corneal melting after ocular surgery in patients with auto-immune disorders]. / Immuunstromale corneale ulceratie na een oogoperatie bij patiënten met collageen-vasculaire auto-immuunaandoeningen.

Two women aged 78 and 74 years respectively, both with dry eyes due to underlying auto-immune disorders, presented after uncomplicated cataract surgery with immunostromal corneal ulceration. Intensive topical lubrication combined with systemic immunosuppressants were necessary to control the corneal melt. Dry eyes are a frequently-encountered problem among patients with rheumatoid disorders and increase the risk of corneal melting. Auto-immune related corneal melting can occur spontaneously or after ocular surgery, it threatens visual acuity and ocular integrity and may be associated with systemic vasculitis. When treating patients with rheumatoid disorders, the presence of dry eyes and the accompanying risk of serious complications need to be ascertained. In patients at risk, pre-operative preventive measures to suppress any underlying systemic disorders and improve the ocular environment are necessary. When corneal melting is diagnosed, aggressive topical therapy combined with systemic immunosuppressants is indicated.

The use of soft bandage contact lenses in the management of primary (localised non-familial) conjunctival amyloidosis: a case report.

We present a case of primary (localised non-familial) conjunctival amyloidosis, which is an uncommon condition, characterised by amyloid deposition within the substantia propria of the conjunctiva. Soft bandage contact lenses were fitted in order to protect the cornea from the mechanical abrasion of the irregular surface of the palpebral conjunctiva. We used non-ionic high water content (70%) soft bandage lenses from Filcon 4A with a Dk of 40. The lenses were well tolerated and gave significant relief of the symptoms.