Two Cases of Keratoconus Associated With Spontaneous Corneal Perforation

Mostafavi, David; Chu, David

doi:10.1097/ico.0b013e3181ac4faa

Cited by 12 publications

(8 citation statements)

References 6 publications

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“…Rubbing or contact lens trauma have a role in hydrops but chiefly the weaker Desçemet's membrane in keratoconus responds to IOP distension 4 . That hydrops is usually associated with rubbing 25 is consistent with trauma due to the associated acute IOP elevation. Hydrops is more common in atopy and Down Syndrome children 4 and both are associated with a higher prevalence of both keratoconus and abnormal rubbing habits 26 .…”

Section: Resultsmentioning

confidence: 99%

“…26 Similarly, corneal perforation in hydrops might be associated with even a single incident of rubbing trauma; 25 however, case reports of hydrops and perforation might be associated with a denial of a history of eye rubbing. 25,27 It is possible that a patient's denial of a history of rubbing in such cases could be based on guilt feelings of self harm. Alternatively, undisclosed rubbing might have occurred during sleep or without awareness.…”

Section: Iop Elevation and Plastic Responses Such As Hydrops And Perfmentioning

confidence: 99%

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The possible significance of the baropathic nature of keratectasias

McMonnies

2013

Clinical and Experimental Optometry

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Background: The aim was to describe the baropathic nature of the keratectasias and to examine the possible significance of intraocular pressure‐elevating activities in the development and/or progression of these conditions. Methods: Articles were selected from 150 produced from a PubMed search for keratectasias and used to elucidate the biomechanics and dependence on intraocular pressure of those conditions. Results: The combination of viscoelastic and baropathic features of keratectasia indicate that elevations in intraocular pressure have the potential to contribute to the development and/or progression of these conditions. Acute events such as hydrops and perforation appear to be more or less dependent on IOP elevation. Conclusion: Development and/or progression of keratectasia might be slowed by patient counselling, which explains the dependence of keratectasia on intraocular pressure and recommends avoidance and/or moderation of activities that elevate intraocular pressure. Successful adoption of such advice could reduce rates of disease progression and the need for refitting with more expensive contact lens designs, which are often required for advanced cases, as well as reduce the need for grafting and the drain on limited availability of donor corneas.

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Section: Resultsmentioning

confidence: 99%

Section: Iop Elevation and Plastic Responses Such As Hydrops And Perfmentioning

confidence: 99%

The possible significance of the baropathic nature of keratectasias

McMonnies

2013

Clinical and Experimental Optometry

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“…6 In cases of corneal perforation in the setting of keratoconus, Stoiber et al 20 reported histological evidence of "fistula" formation. 21 Each of the cases reported here had serological investigations performed to exclude autoimmune associations, and 2 of the 3 patients had corneal swabs to exclude herpetic eye disease. There was no history of trauma immediately before any of the perforations.…”

Section: Discussionmentioning

confidence: 98%

Direct Surgical Repair of Corneal Perforation in Pellucid Marginal Degeneration

Chan

Snibson²,

Poon³

2013

Cornea

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“…Although the exact etiology of corneal hydrops is unclear, it is often associated with progressive ectatic disease, severe allergic eye disease, and habitual eye rubbing [ 2 ]. Rare cases can cause perforation and fistula formation [ 3 ]. In keratoconus patients, the onset of hydrops is generally spontaneous and proportional to the degree of corneal steepening [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

Corneal Hydrops Secondary to Intrastromal Corneal Ring Intrusion into the Anterior Chamber 7 Years after Implantation: A Case Report

et al. 2017

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IntroductionThis report describes the first known case of late-onset intrusion of an intrastromal ring segment into the anterior chamber due to posterior migration of a ring segment. To our knowledge, intrastromal ring segment penetration has only been shown to occur in the intraoperative or immediate postoperative period. We postulate that the perforation in this case is due to progressive thinning of the cornea, possibly in combination with habitual eye rubbing.Case ReportA 44-year-old man presented with acute corneal hydrops related to penetration of Descemet’s membrane and endothelium by an intrastromal ring segment implanted 7 years prior. Removal of the ring segment resulted in an anterior chamber fistula that directed fluid through the ring segment tunnel to the ocular surface. Leakage of aqueous humor was successfully controlled, and corneal edema gradually resolved.ConclusionThis case indicates the need for long term monitoring of ring segment proximity to the posterior corneal surface, especially in patients with ectatic ocular conditions and/or habitual eye rubbing behavior.

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Two Cases of Keratoconus Associated With Spontaneous Corneal Perforation

Cited by 12 publications

References 6 publications

The possible significance of the baropathic nature of keratectasias

The possible significance of the baropathic nature of keratectasias

Direct Surgical Repair of Corneal Perforation in Pellucid Marginal Degeneration

Corneal Hydrops Secondary to Intrastromal Corneal Ring Intrusion into the Anterior Chamber 7 Years after Implantation: A Case Report

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