Crescent-shaped anterior lamellar keratoplasty as treatment of corneal perforation in peripheral ulcerative keratitis

Abstract

Purpose: to raise awareness of potential severe ocular complications associated with autoimmune diseases and to describe the surgical technique of crescent-shaped anterior lamellar keratoplasty to treat a corneal perforation in peripheral ulcerative keratitis. Methods and Materials: Case report. Results: A female patient with 59 years old, with history of longstanding rheumatoid arthritis, presented with redness and photophobia in the right eye. As past ocular history, the patient had a severe keratoconjunctivitis sicca and a corneal ulcer in the right eye. Clinical examination revealed an epithelial defect with a significant inferior corneal thickness decrease. Topical steroids, antibiotics and a therapeutic contact lens were prescribed. One month later, a corneal perforation was observed and a crescent-shaped deep anterior lamellar keratoplasty was then performed. Conclusion: The clinical course of peripheral ulcerative keratitis depends on the associated systemic pathology, being essential a multidisciplinary approach by ophthalmologists and rheumatologists to allow systemic control of the autoimmune disease, avoiding possible complications such as eye perforation.