title: Corneal perforation after conductive keratoplasty with previous refractive surgery.
abstract: A 56-year-old woman had conductive keratoplasty (CK) for residual hyperopia and astigmatism. Three years before the procedure, the patient had arcuate keratotomy, followed by laser in situ keratomileusis 2 years later for high astigmatism correction in both eyes. During CK, a corneal perforation occurred in the right eye; during the postoperative examination, an iris perforation and anterior subcapsule opacification were seen beneath the perforation site. The perforation was managed with a bandage contact lens and an antibiotic-steroid ointment; it had a negative Seidel sign by the third day. The surgery in the left eye was uneventful. Three months after the procedure, the uncorrected visual acuity was 20/32 and the best corrected visual acuity 20/20 in both eyes with a significant improvement in corneal topography. Care must be taken to prevent CK-treated spots from coinciding with areas in the corneal stroma that might have been altered by previous refractive procedures.
authors.affiliation: Department of Ophthalmology, Vardinoyannion Eye Institute of Crete, University of Crete, Heraklion, Greece. kymionis@med.uoc.gr
authors.forename: George D
authors.initials: GD
authors.lastname: Kymionis
authors.forename: Patrik
authors.initials: P
authors.lastname: Titze
authors.forename: Marinos M
authors.initials: MM
authors.lastname: Markomanolakis
authors.forename: Ioannis M
authors.initials: IM
authors.lastname: Aslanides
authors.forename: Ioannis G
authors.initials: IG
authors.lastname: Pallikaris
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use; D001251:Astigmatism / Q000601:surgery; D003316:Corneal Diseases / Q000209:etiology*; D003319:Corneal Stroma / Q000601:surgery*; D004564:Electrocoagulation / Q000009:adverse effects*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D006956:Hyperopia / Q000601:surgery*; D007499:Iris Diseases / Q000209:etiology; D020731:Keratomileusis, Laser In Situ; D007646:Keratotomy, Radial; D007903:Lens Capsule, Crystalline / Q000473:pathology; D007905:Lens Diseases / Q000209:etiology; D008875:Middle Aged; D009779:Occlusive Dressings; D011846:Radio Waves; D012422:Rupture, Spontaneous; D014792:Visual Acuity
chemical_list: D000890:Anti-Infective Agents; D005938:Glucocorticoids