Successful nonsurgical management of corneal perforation in a patient with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy.
OBJECTIVE
To describe a patient with a history of autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) who has experienced two episodes of noninfectious corneal ulceration with perforation that has been successfully managed with nonsurgical therapy.


METHODS
Case report.


RESULTS
An 18-year-old male with a history of APECED has been followed up with recurrent keratoconjunctivitis and episodes of microbial keratitis since 4 years of age. Ophthalmic complications have included two episodes of sterile corneal ulceration associated with corneal perforation. These episodes of stromal ulceration associated with a flat anterior chamber were managed with a bandage contact lens, topical antibiotics, and a topical cycloplegic agent. In one instance, addition of cyclosporine led to reformation of the anterior chamber and arrest of the ulcerative process.


CONCLUSIONS
Sterile corneal ulceration and perforation associated with APECED may be managed medically to avoid surgical intervention, which has been reported to lead to a poor outcome.
Cullen Eye Institute, Baylor College of Medicine, Houston, TX 77030, USA.
Steven
S
Yeh
Alice Y
AY
Matoba
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D003261:Contact Lenses; D003320:Corneal Ulcer / Q000382:microbiology / Q000628:therapy*; D015818:Eye Infections, Bacterial / Q000382:microbiology / Q000628:therapy; D006801:Humans; D007637:Keratoconjunctivitis / Q000628:therapy; D008297:Male; D009184:Mydriatics / Q000008:administration & dosage*; D016884:Polyendocrinopathies, Autoimmune / Q000628:therapy*; D012422:Rupture, Spontaneous; D013203:Staphylococcal Infections / Q000382:microbiology / Q000628:therapy; D013211:Staphylococcus aureus / Q000302:isolation & purification
D000900:Anti-Bacterial Agents; D009184:Mydriatics