Acute sclerokeratitis after cataract surgery: treatment with topical use of cyclosporine - a

Abstract

We would like to report an interesting case of acute sclerokeratitis following cataract surgery treated with topical use of Cyclosporine-A. A 61-year old woman with a past history of scleritis in her right eye had an uneventful phaco surgery in her right eye for cataract removal via a corneoscleral incision. Eight months after the initial surgery the patient had a sudden decrease in her visual acquity in the right eye with marked inflammatory signs in the sclera and cornea adjacent to the entry-site of the phaco surgery. Initially the patient was treated with systemic corticosteroids but due to serious side effects topical cyclosporine-A was added instead. Five months later the patient has a significant improvement in terms of visual acquity with marked reduction in the inflammatory signs both in sclera and corneal tissue. We think that topical Cyclosporine-A with its potent immunomodulating effects seems to be of benefit in those cases where systemic corticosteroids are contraindicated or have serious side-effects.

Fig. (1).

Colour photo of the patient right eye. Intense inflammation of scleral tissue as well as neovascularization of the cornea adjacent to the cataract incision site.

Fig. (2).

After treatment with topical Cyclosporine-A 1% there is reduction of the neovascularization in the cornea and the appearance of scar tissue in upper corneal stroma.