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ANOTHER CLINICAL CASES

Corneal Perforation - Exposure Keratopathy

Clinical Case 01

Corneal Perforation - Exposure Keratopathy - Clinical Case 01

Corneal perforation (LE), secondary to Exposure Keratopathy, was a postanesthetic complication of cardiac surgery, in a diabetic patient with renal insufficiency and high myopia.

Corneal Perforation - Exposure Keratopathy - Clinical Case 01

VA 3L 20/70 through ectopic pupil performed with Yag laser. The corneal hole was closed with scleral rectangular fragment (free) at the corneal endothelial surface, incarcerated in limbus, and the anterior chamber was tamponated with C3F8 gas.

Evaluations

1st evaluation

3 0

28 05 2014 - Colour Retinography

A male patient complained of sudden loss of vision at the left eye after Valsalva maneuver - subretinal hemorrhage at macular area. Diabetic with renal insufficiency and hight myopia. BCVA: 6/10 LE. It is the patient only eye.
Patients with ocular pathologies (acquired retinal vascular abnormalities, congenital retinal vascular disease, moderate and high myopia) are at increased risk for Valsalva retinopathy.

Fundus photograph 1 month after presentation, showing partial reabsorption of hemorrhage. BCVA: 20/30

Fundus photograph 2 months after presentation, showing total reabsorption of hemorrhage. BCVA: 20/30

2nd evaluation

4 0

04 09 2015 - Anterior Segment Photo

Dislocation of intraocular lens within the capsular bag, eighteen months after presentation

Two moths after Intraocular Lens Dislocation Surgery

Dislocation of intraocular lens, 3 years after presentation

1 day after Intraocular Lens Dislocation Surgery

3rd evaluation

1 0

16 08 2018 - Anterior Segment Photo

Exposure Keratopathy after cardiac surgery, due to prolonged exposure of the cornea to the outside environment

4th evaluation

1 0

10 09 2018 - OCT B-Scan (Longitudinal)

Retinal detachment, 4 years after the 1st evaluation

5th evaluation

12 0

28 09 2018 - Anterior Segment Photo

A silicone oil bubble in the anterior chamber, 1 week after retinal detachment surgery

Exposure Keratopathy

Fungal infection

Corneal neovascularisation, corneal folds and silicone in the anterior chamber.

Corneal perforation

Corneal perforation (magnification)

5th evaluation - postoperative

12 0

28 09 2018 - Anterior Segment Photo

A silicone oil bubble in the anterior chamber, 1 week after retinal detachment surgery

Exposure Keratopathy after cardiac surgery

Fungal infection

Corneal neovascularisation, corneal folds and silicone in the anterior chamber.

Corneal perforation

Corneal perforation (magnification)

6th evaluation - postoperative

13 0

14 11 2018 - Anterior Segment Photo

One day after surgery.The corneal hole was closed with free scleral rectangular fragment at the corneal endothelial surface, incarcerated in limbus, and the anterior chamber was tamponated with C3F8 gas.

Two days after surgery.

Six days after surgery.

Six days after surgery.

One week after surgery.

Eight days after surgery.

Nine days after surgery.

Two weeks after surgery. Removal of the scleral flap

The corneal hole was sealed. One month afer surgery

Two months afer surgery

Three months afer surgery

Three months afer surgery

7th evaluation

9 0

29 04 2019 - Anterior Segment Photo

Iridectomy onset

Ectopic pupil performed with Yag laser.

29 04 2019 - Corneal Topography

8th evaluation

3 0

19 06 2019 - Anterior Segment Photo

VA 20/300 through ectopic pupil, seven months after surgery. The corneal hole was closed with free scleral rectangular fragment at the corneal endothelial surface, incarcerated in limbus, and the anterior chamber was tamponated with C3F8 gas. Silicone bubble in the anterior chamber

19 06 2019 - Colour Retinography

Ultra-widefield photograph.Vitreous cavity partially buffered with silicone oil.

19 06 2019 - Corneal Topography

9th evaluation

3 0

17 07 2019 - Anterior Segment Photo

VA 20/300 through ectopic pupil performed with Yag laser, eight months after surgery.The corneal hole was closed with free scleral rectangular fragment at the corneal endothelial surface, incarcerated in limbus, and the anterior chamber was tamponated with C3F8 gas. Silicone bubble in the anterior chamber

17 07 2019 - Colour Retinography

Ultra-widefield photograph.Vitreous cavity partially buffered with silicone oil.

OCT. VA 20/300 through ectopic pupil

10th evaluation - postoperative

3 0

26 09 2019 - Anterior Segment Photo

The silicone oil was removed from anterior chamber and vitreous cavity. VA: 3L 20/70 one month after surgery

26 09 2019 - Colour Retinography

Ultra-widefield photograph.The silicone oil was removed from vitreous cavity. Note the vitreous cavity partially buffered with gas.

26 09 2019 - OCT B-Scan (Longitudinal)

OCT. VA 3L 20/70 through ectopic pupil

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