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Corneal Ring Infiltrate Following Micropulse Cyclophotocoagulation.

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Neurotrophic keratopathy (NK) after micropulse cyclophotocoagulation (MP-CPC) can mimic infections with a ring infiltrate. Early diagnosis and preoperative corneal health assessment are crucial, especially for diabetic patients, to prevent complications.

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Area of Science:

  • Ophthalmology
  • Corneal Diseases
  • Glaucoma Surgery

Background:

  • Neurotrophic keratopathy (NK) is a condition affecting corneal health.
  • Micropulse cyclophotocoagulation (MP-CPC) is a treatment for glaucoma.
  • NK can present atypically, posing diagnostic challenges.

Purpose of the Study:

  • To report a case of NK following MP-CPC presenting as a ring infiltrate.
  • To describe diagnostic challenges associated with this presentation.
  • To emphasize the importance of preoperative corneal assessment in at-risk patients.

Main Methods:

  • A case report of a 36-year-old diabetic woman with neovascular glaucoma treated with MP-CPC.
  • Clinical examination including visual acuity, corneal sensitivity, and slit lamp findings.
  • Diagnostic workup including corneal scrapings to exclude infectious keratitis.
  • Treatment involved conservative measures, followed by amniotic membrane grafting.

Main Results:

  • The patient developed a corneal ring infiltrate and epithelial defect post-MP-CPC.
  • Initial conservative treatment failed; amniotic membrane grafting led to complete healing.
  • Residual corneal scarring was noted after healing.

Conclusions:

  • Neurotrophic keratopathy can present as a corneal ring infiltrate, mimicking infectious keratitis.
  • Preoperative assessment of corneal sensation is recommended for patients undergoing MP-CPC, particularly diabetics.
  • Close monitoring and tailored treatment protocols are vital to prevent severe ocular complications after MP-CPC.