Management of 360° Peripheral Ulcerative Keratitis with Cataract in a One-Eyed: A Challenging Scenario

Abstract

Abstract The purpose of this study is to discuss the management of 360° peripheral ulcerative keratitis with cataract in a patient with only one functioning eye. Peripheral ulcerative keratitis (PUK) is a type of crescent-shaped inflammatory damage that occurs in the limbal region of the cornea. PUK is always combined with an epithelial defect and the destruction of the peripheral corneal stroma. This is a case of a 78-year-old male who presented to us with complaints of redness in his right eye for the last year, with similar recurrent episodes on and off for the last 3 weeks. Examination revealed his right eye anterior segment having 360° peripheral ulcerative keratitis with dense brown hard cataract, and the uncorrected visual acuity was finger counting at 3 metres. At this point of the first examination, the eye was inflamed, so we decided to treat this patient in a phased manner. Phase-1 included a planned 360° amniotic membrane grafting when the eye is rendered quiet, followed by cataract extraction for the patient’s rehabilitation. This case demonstrates the approach we should consider in such cases, with a good result of accomplishing both phases and achieving a best-corrected visual acuity of 6/12 with a pinhole of 6/9.