A Combined Approach To The Treatment Of Exposure Keratopathy In A Patient With Thyroid Eye Disease
Published 2022 - 40th Congress of the ESCRS
Reference: PO326 | Type: ESCRS 2022 - Posters | DOI: 10.82333/v9wd-x891
Authors: Cristina Tan* 1 , Victor Caparas 1
1Eye and Vision Institute,The Medical City,Pasig City,Philippines
Purpose
We present the management of exposure keratopathy in a patient with Grave's disease. A combination of bilateral conjunctival peritomy with amniotic membrane transplantation was performed.
Setting
The Eye and Vision Institute at The Medical City, Pasig, Philippines
Methods
A 53 year-old female with Thyroid eye disease presented with bilateral inferior corneal stromal thinning secondary to diffuse conjunctival chemosis. Tarsorrhaphy was not performed due to the advanced proptosis. A conjunctival peritomy was performed in theater to flatten the raised limbal areas and sutured with Vicryl 8-0. Amniotic membrane was applied over the inferior stromal thinning and sutured to the peripheral cornea with Nylon 10-0. A bandage contact lens was subsequently applied.
Results
Eight weeks later, chemosis has greatly improved with resolution of stromal thinning bilaterally. Amniotic membranes have resorbed and sutures were removed.
Conclusions
Thyroid Eye Disease may lead to ocular surface complications such as exposure keratopathy and subsequently stromal thinning. Conjunctival peritomy was able to flatten the raised limbal edges and in combination with the amniotic membrane prevented further inferior stromal dessication and thinning.