Corneal Perforation And Upper Blepharoplasty: A Rare, But Possible, Combination

The purpose of this e-poster is to present a case report of a healthy 45 years old Caucasian male referred to our Emergency Eye Department for a corneal perforation in the right eye. The day before the patient had undergone a bilateral upper eyelid radiofrequency blepharoplasty at an outside private clinic.

Ophthalmology Unit, Department of Medical, Surgical and Neurosciences Siena University, Italy

While taking his past and present ocular history, the patient revealed to have undergone a bilateral upper eyelid radiofrequency blepharoplasty the day before at an outside private clinic. He did not report any other relevant information which may have been associated with his ocular symptoms.
A visual acuity test was initially performed, followed by a slit lamp examination with a scrupulous anterior segment evaluation and a complete fundus assessment. Moreover anterior segment optical coherence tomography (AS-OCT) (Spectralis Heidelberg Engineering, Heidelberg, Germany) images were taken as well as posterior segment images

The patient showed a severe vision reduction from 20/20 to 20/400, ocular redness and pain in the right eye. A very shallow anterior chamber, a supero-temporal paracentral full thickness corneal perforation confirmed also by a positive Seidel test and AS-OCT, a peaked iris and an annular choroidal detachment were detected as well.
A protective corneal lens was applied and Atropine 1%, three different antibiotics (ofloxacin, netilmicin, chloramphenicol) were prescribed. A tight follow up was advised, hoping to reduce the chances for possible complications.
After one week his corneal lesion reduced without any surgical procedure to a partial thickness corneal laceration and his anterior chamber appeared deep and quiet.

The management of corneal perforation mainly depends on its cause, size, location and shape with many different approaches often used in a multistage fashion. Traumatic corneal perforation whose diameter is inferior to 2-3 mm may be managed with conservative treatments such as corneal lens, sutures, cyanoacrilate or fibrin glue, conjunctival flap, amniotic membrane transplantation or Tenon’s patch graft whereas greater lesion may require corneal transplantation.
The patient managed to achieve a good vision recovery (20/25 at his final visit at our center) 4 months after his blepharoplasty without having ever reported any complications. The patient then decided to be followed by a private ophthalmologist