| 발표일자: |
2019년 4월 5일(금)~7(일) |
| 발표번호: |
P(e-poster)-277 |
| 발표장소: |
벡스코 전시장 1홀 내 |
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| Bilateral Peripheral Ulcerative Keratitis after Bilateral Pterygium Surgery |
| Department of Ophthalmology, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University |
| Chunhakan Petpansri, M.D.1
Thanita Hlowchitsieng, M.D.1, 2
Onsiri Thanathanee, M.D.1
Olan Suwan-apichon, M.D.1
Orapin Anutarapongpan, M.D.1
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Purpose : To report a case of bilateral peripheral ulcerative keratitis (PUK) in a patient with type 1 diabetes mellitus who underwent bilateral pterygium surgery.
Methods: A 29-year-old women with type 1 diabetes mellitus presented with a history of 5 months pain, redness and blurred vision in both eyes. She had bi-head pterygium in both eyes. Seven months previously she had undergone pterygium excision with amniotic membrane transplantation to the left eye. Furthermore, the right was done with same technique 5 days later. Visual acuity was 20/80 OD and finger counting 1 foot OS. Slit-lamp examination revealed PUK with conjunctival injection both eyes. The fundus of both eyes showed generalized cotton wool spots.
Methods : -
Results : Laboratory investigations showed an elevated erythrocyte sedimentation rate, perinuclear anti-neutrophil cytoplasmic antibodies and anti-proteinase 3 was positive. Normal chest X-ray. Poorly controlled diabetes mellitus with HbA1C 8.9. PUK was treated with systemic steroids, an immunomodulatory drug and artificial tears. Conjunctival recession and resection were performed in both eyes. After 2 weeks of treatment, corneal thinings were improved.
Conclusion : This case illustrates that PUK may be activated after pterygium surgery. Diabetes mellitus causes varying degrees of vaso-occlusion of arterial, venous and capillary circulation. Vasculopathy may lead to resorption of stromal tissue that can cause PUK. To the best of our knowledge, this is the first case of PUK in a patient with type 1 diabetes mellitus. Although the incidence is rare but if this occurs, it can lead to serious complications and an unfavorable visual outcome.
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