Sterile Corneal Perforation Occurring Several Years After Biliopancreatic Diversion
Giuseppe Giannaccare1, Andrea Lucisano2, Marco Pellegrini3
1Department of Ophthalmology, University of "Magna Graecia", Viale Europa, 88100, Catanzaro, Italy. giuseppe.giannaccare@gmail.com.
Background:
To report the first two cases of sterile corneal perforation secondary to vitamin A deficiency after biliopancreatic diversion with duodenal switch (BPD/SW).
Methods:
Observational case series.
Results:
Two patients with a history of BPD/SW presented with corneal perforation associated with conjunctival xerosis and keratopathy. In both cases, serum vitamin A level dosage revealed a marked deficit, and the patients admitted poor compliance with vitamin supplementation. Oral therapy with vitamin A was started immediately, and in one case ocular surgery was performed to preserve the integrity of the globe.
Conclusions:
Ophthalmologists should carefully examine the ocular surface of patients undergone bariatric surgery in order to promptly recognize the signs of vitamin A deficiency and avoid serious sight-threatening complications.
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