Acute corneal melting one week after an uncomplicated cataract surgery in a patient who previously underwent eyelid radiation and with undiagnosed rheumatoid arthritis: a case report

Ceratomalácia aguda uma semana após cirurgia de catarata sem complicações em uma paciente com irradiação prévia de uma pálpebra e artrite reumatoide não diagnosticada: relato de caso

ABSTRACT

This is a rare case report of acute, paracentral corneal melting and perforation occurring 1 week after an uneventful cataract surgery, with discussions on possible pathogenetic mechanisms. Relevant literature was also reviewed. Herein, a case of an 86-year-old woman with acute, paracentral, and sterile corneal melting and perforation in her left eye at 1 week after an uncomplicated cataract extraction is described. This occurs at the base of ocular surface disorders due to previous radiation of her lower eyelid and cheeks for the treatment of cancer and previously undiagnosed rheumatoid arthritis. She underwent surgical treatment using Gundersen’s conjunctival flap for the existing perforation due to low visual expectancies and reluctance to undergo corneal keratoplasty due to the risk of corneal graft rejection. The risk of coming across an acute corneal melting after an uncomplicated cataract surgery in the eyes with ocular surface disorders should always be considered.

Keywords:
Corneal perforation; Radiation; Rheumatoid arthritis; Cataract extraction