Late Spontaneous Postradial Keratotomy Corneal Perforation After Scleral Contact Lens Use—Case Report

Abstract

Purpose: 

To describe a case of late spontaneous postradial keratotomy corneal perforation after scleral contact lens (SCL) wear for optic correction.

Setting: 

Tertiary referral center for corneal pathology.

Design: 

Case report.

Results: 

A 64-year-old man presented the consequences of a late radial keratotomy (RK) surgery performed for myopia correction 26 years ago. His ophthalmologic history was a RK in both eyes (BE), previous Lasik surgery in BE and Lasik enhancement in the right eye (RE), and pterygium excision with conjunctival transplantation in RE. To improve visual acuity, SCL were fitted in both eyes. After 8 months of use, on a certain day, when removing the lens from the RE, the patient reported experiencing intense eye pain and reduced visual acuity. On ophthalmologic examination, the RE cornea was perforated in one of the previous RK incisions. An urgent corneal transplant was performed in the RE, followed by cataract surgery in the same eye.

Conclusion: 

Corneal instability caused by RK scars and daily manipulation with the SCL use may have led to ocular perforation.