[Bilateral corneal endothelial decompensation after postsepticemia coma].
We report a case of unexplained bilateral corneal endothelial decompensation after a coma. A 71-year-old man with no medical history presented with bilateral endothelial decompensation that required penetrating keratoplasty of the left eye combined with cataract surgery. This coma was caused by septicemia originally due to staphylococcus infection following catheter placement in preparation for a CT scan. Visual acuity of the left eye was 20/400 and 20/100 in the right eye when the patient awoke from the coma. After examination, we noted only stromal thickening and Descemet membrane folds causing corneal edema predominating OS. The rest of the exam was normal. Six months after surgery, visual acuity improved to 20/25. The most probable physiopathological mechanism of this decompensation is an iatrogenic complication from drugs administered during the patient's stay in intensive care (oxacillin), but we cannot rule out direct aggression of a bacterium or its toxin or the decompensation of a preexisting pathology.
Federici
L
L
Service d'Ophtalmologie, Hôpital La Timone, Marseille.
Proust
H
H
Conrath
J
J
Ridings
B
B
D000368:Aged; D003128:Coma / Q000150:complications*; D003316:Corneal Diseases / Q000209:etiology*; D004728:Endothelium, Corneal; D006801:Humans; D008297:Male; D018805:Sepsis / Q000150:complications*; D013203:Staphylococcal Infections / Q000150:complications*