Corneal perforation after corneal foreign body - Case Report.

Purpose: To present the case of a patient with a history of trauma and corneal foreign body in the right eye, followed by decreased visual acuity in the right eye, corneal perforation with good recovery after surgical treatment. Material and method: We report a case of a patient who presented to our clinic with a sudden decrease of visual acuity in the right eye, two months after an incident resulting in a corneal foreign body in the right eye. In the case presented, the patient applied a local medical self-treatment, an antibiotic and a topical corticosteroid. After a few weeks, the patient presented to the ophthalmologist, a foreign body was extracted from the cornea of the right eye and a topical treatment with a non-steroidal anti-inflammatory drug, a cycloplegic and an antibiotic were indicated. However, corneal perforation occurred and the patient was urgently sent to our service, where a corneal anaesthesia was also found. Results: Corneal perforation healed with a minor paracentral opacification. Discussions: Corneal perforation in our patient was due to corneal melting because of topical steroid anti-inflammatory autotherapy, late corneal foreign body extraction and topical treatment with non-steroidal anti-inflammatory drugs. Corneal anesthesia is also an important factor that enhances corneal melting and perforation. The surgical intervention performed healed the corneal perforation. Conclusions: Corneal anaesthesia and topical anti-inflammatory administration led to corneal perforation. Corneal sensitivity should be tested in patients with corneal foreign body. Corneal patching proved to be an adequate solution in this patient.

Phacoemulsification in adult patients with post-uveitis complicated cataract.

Objective: To evaluate the difficulties, complications and outcome of cataract surgery in patients with complicated cataract after anterior uveitis. Methods: A retrospective study on 37 patients who suffered phacoemulsification surgery for post-uveitis complicated cataract in the period 2009-2014 was performed. 43 eyes underwent surgery. Results: Posterior synechiae were present in 25 eyes. Posterior synechiolysis ensured large pupil in 15 eyes, and, in 14 eyes, the use of iris hooks or pupil expansion ring was necessary for surgery. Posterior capsule rupture was reported in 1 eye. Opacified and thick posterior capsule was noticed in 6 eyes. After surgery, transient rising of intraocular pressure was noticed in 4 eyes and prolonged postoperative inflammation was present in 3 eyes. Posterior capsule opacification was the most frequent issue (9 eyes) and cystoid macular oedema was reported in 2 eyes. Conclusions: Post-uveitis complicated cataract surgery presents specific difficulties and postoperative complications are present in these patients, like prolonged postoperative inflammation and cystoid macular oedema.

Conjunctival autograft in pterygium treatment.

Pterygium is characterized by the thickening of the bulbar conjunctiva and the invasion of the cornea from the sclerocorneal limbus to the central portion of the cornea. Pterygium produces corneal deformation, which extends toward the central portion of the cornea. The visual disorders depend on the corneal extent. The treatment goal is the removal of the corneal and conjunctival portion of the pterygium and the coverage of the resulting conjunctival defect. The association of the pterygium surgical excision was assessed with conjunctival autograft. For this purpose, a retrospective study was performed on 68 patients and was extended over 7 years (2009-2015). Patients with recurrent pterygium were excluded. The time for corneal re-epithelization and for the pain and photophobia disappearance was followed. The incidence of recurrence was also observed. Pain levels were assessed by using a 10-point visual analog linear scale (VAS). The mean time for ocular pain and photophobia disappearance was of 48 hours. The mean pain score was 3.38 at 24 hours after surgery. Corneal re-epithelialization was achieved in 60 hours after surgery. Recurrence occurred in 6 patients. It was concluded that pterygium surgical excision with conjunctival autograft is effective in pterygium surgery.