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A rare case of peripheric ulcerative keratitis (PUK) and corneal perforation associated with hyperuricemia as only systemic disease

Poster Details

First Author: S.Martin-Nalda SPAIN

Co Author(s):    A. Segura   J. Puig-Galy   M. Calatayud   L. Bisbe   P. Laso   L. De Nicola     

Abstract Details


To describe a case with satisfactory results of PUK and corneal perforation treated with amniotic membrane, conjunctival flap and oral mycophenolate.


Cornea and ocular surface unit, Uveitis and ocular inflammation unit, Vall d Hebron Hospitals. Barcelona (Spain)


A 48-year-old caucasian male was referred to our centre because of left eye peripheric corneal perforation. The patient had been suffering of bilateral episodes of epiescleritis for two years, specially his left eye, having been treated with both topical and oral steroids and an antiviral oinment with no improvement


The patient underwent to an emergency amniotic membrane transplantation. An analytical complete study with serum antibodies was realized together with a torax X-ray in order to discover a systemic disease. The only result was a hyperuricemia with migratory inflammation of big joints that was treated. The patient started oral mycophenolate but in a month the perforation reopened and a conjunctival sliding flap was performed and the dose of mycophenolate was increased. After 5 months the perforation was sealed with a complete restoration of the eye anatomy and visual acuity.


PUK with corneal perforation should be managed with immunosuppression. In this case we only found the hyperuricemia as systemic disease and maybe it had been the trigger of the epiescleritis and inflammation. The conjunctival flap in these cases is probed to be an useful surgical technique to restore ocular anatomy.

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