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[Bilateral corneal endothelial decompensation after postsepticemia coma].
L Federici1, H Proust, J Conrath
1Service d'Ophtalmologie, Hôpital La Timone, Marseille.
Journal Francais D'Ophtalmologie
|August 4, 2006
Summary
A coma caused by staphylococcus infection led to unexplained bilateral corneal endothelial decompensation. Treatment improved vision, but iatrogenic drug complications or infection are suspected causes.
Area of Science:
- Ophthalmology
- Critical Care Medicine
- Infectious Disease
Background:
- Corneal endothelial decompensation can lead to vision loss.
- Septicemia can have various systemic and ocular complications.
Observation:
- A 71-year-old man developed bilateral corneal edema and reduced visual acuity after a coma induced by Staphylococcus septicemia.
- Ocular examination revealed stromal thickening and Descemet membrane folds, predominantly in the left eye.
Findings:
- The patient underwent successful penetrating keratoplasty and cataract surgery in the left eye, with visual acuity improving to 20/25 six months post-surgery.
- Potential causes for the corneal decompensation include iatrogenic complications from medications (oxacillin), direct bacterial or toxin effects, or decompensation of a pre-existing condition.
Implications:
- This case highlights a rare complication of critical illness and its management.
- Understanding the underlying mechanism is crucial for preventing similar ocular issues in critically ill patients.