Corneal ulceration in a LASIK patient due to vitamin a deficiency after bariatric surgery

Kendall Donaldson, Jane Fishler

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Purpose: To review the case of a 41-year-old woman who underwent bariatric surgery in 2000. She subsequently underwent laser in situ keratomileusis (LASIK) surgery in 2008 and complained of dry eye since the LASIK surgery. In November 2010, she was diagnosed with a corneal melt and was treated with aggressive lubrication, followed by eventual amniotic membrane placement and a tarsorrhaphy. She then presented for consultation at the Bascom Palmer Eye Institute when she developed a corneal infiltrate. She was diagnosed with fungal keratitis with corneal xerosis. At that time, vitamin A levels were measured and were less than 2 μ/dL. The patient admitted noncompliance with nutritional supplements. Methods: Case report. Results: The patient was treated with aggressive lubrication and natamycin. Vitamin supplements were restarted, and the patient experienced dramatic improvement in symptoms with resolution of the infection. A central corneal scar with corneal thinning remains. The patient underwent a penetrating keratoplasty for visual rehabilitation. Conclusions: Patient education with emphasis on compliance with nutritional supplements is essential after bariatric surgery. Consider vitamin A deficiency in the differential diagnosis of dry eye after LASIK surgery.

Original languageEnglish
Pages (from-to)1497-1499
Number of pages3
JournalCornea
Volume31
Issue number12
DOIs
StatePublished - Dec 1 2012

Fingerprint

Avitaminosis
Laser In Situ Keratomileusis
Bariatric Surgery
Lubrication
Natamycin
Vitamin A Deficiency
Penetrating Keratoplasty
Amnion
Keratitis
Patient Education
Patient Compliance
Vitamin A
Vitamins
Differential Diagnosis
Referral and Consultation
Rehabilitation
Infection

Keywords

  • bariatric surgery
  • dry eye
  • gastric bypass
  • keratoconjunctivitis sicca
  • LASIK
  • vitamin A

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Corneal ulceration in a LASIK patient due to vitamin a deficiency after bariatric surgery. / Donaldson, Kendall; Fishler, Jane.

In: Cornea, Vol. 31, No. 12, 01.12.2012, p. 1497-1499.

Research output: Contribution to journalArticle

@article{225701eb535f4d72ba0f29c01a81bf1c,
title = "Corneal ulceration in a LASIK patient due to vitamin a deficiency after bariatric surgery",
abstract = "Purpose: To review the case of a 41-year-old woman who underwent bariatric surgery in 2000. She subsequently underwent laser in situ keratomileusis (LASIK) surgery in 2008 and complained of dry eye since the LASIK surgery. In November 2010, she was diagnosed with a corneal melt and was treated with aggressive lubrication, followed by eventual amniotic membrane placement and a tarsorrhaphy. She then presented for consultation at the Bascom Palmer Eye Institute when she developed a corneal infiltrate. She was diagnosed with fungal keratitis with corneal xerosis. At that time, vitamin A levels were measured and were less than 2 μ/dL. The patient admitted noncompliance with nutritional supplements. Methods: Case report. Results: The patient was treated with aggressive lubrication and natamycin. Vitamin supplements were restarted, and the patient experienced dramatic improvement in symptoms with resolution of the infection. A central corneal scar with corneal thinning remains. The patient underwent a penetrating keratoplasty for visual rehabilitation. Conclusions: Patient education with emphasis on compliance with nutritional supplements is essential after bariatric surgery. Consider vitamin A deficiency in the differential diagnosis of dry eye after LASIK surgery.",
keywords = "bariatric surgery, dry eye, gastric bypass, keratoconjunctivitis sicca, LASIK, vitamin A",
author = "Kendall Donaldson and Jane Fishler",
year = "2012",
month = "12",
day = "1",
doi = "10.1097/ICO.0b013e318243e4ac",
language = "English",
volume = "31",
pages = "1497--1499",
journal = "Cornea",
issn = "0277-3740",
publisher = "Lippincott Williams and Wilkins",
number = "12",

}

TY - JOUR

T1 - Corneal ulceration in a LASIK patient due to vitamin a deficiency after bariatric surgery

AU - Donaldson, Kendall

AU - Fishler, Jane

PY - 2012/12/1

Y1 - 2012/12/1

N2 - Purpose: To review the case of a 41-year-old woman who underwent bariatric surgery in 2000. She subsequently underwent laser in situ keratomileusis (LASIK) surgery in 2008 and complained of dry eye since the LASIK surgery. In November 2010, she was diagnosed with a corneal melt and was treated with aggressive lubrication, followed by eventual amniotic membrane placement and a tarsorrhaphy. She then presented for consultation at the Bascom Palmer Eye Institute when she developed a corneal infiltrate. She was diagnosed with fungal keratitis with corneal xerosis. At that time, vitamin A levels were measured and were less than 2 μ/dL. The patient admitted noncompliance with nutritional supplements. Methods: Case report. Results: The patient was treated with aggressive lubrication and natamycin. Vitamin supplements were restarted, and the patient experienced dramatic improvement in symptoms with resolution of the infection. A central corneal scar with corneal thinning remains. The patient underwent a penetrating keratoplasty for visual rehabilitation. Conclusions: Patient education with emphasis on compliance with nutritional supplements is essential after bariatric surgery. Consider vitamin A deficiency in the differential diagnosis of dry eye after LASIK surgery.

AB - Purpose: To review the case of a 41-year-old woman who underwent bariatric surgery in 2000. She subsequently underwent laser in situ keratomileusis (LASIK) surgery in 2008 and complained of dry eye since the LASIK surgery. In November 2010, she was diagnosed with a corneal melt and was treated with aggressive lubrication, followed by eventual amniotic membrane placement and a tarsorrhaphy. She then presented for consultation at the Bascom Palmer Eye Institute when she developed a corneal infiltrate. She was diagnosed with fungal keratitis with corneal xerosis. At that time, vitamin A levels were measured and were less than 2 μ/dL. The patient admitted noncompliance with nutritional supplements. Methods: Case report. Results: The patient was treated with aggressive lubrication and natamycin. Vitamin supplements were restarted, and the patient experienced dramatic improvement in symptoms with resolution of the infection. A central corneal scar with corneal thinning remains. The patient underwent a penetrating keratoplasty for visual rehabilitation. Conclusions: Patient education with emphasis on compliance with nutritional supplements is essential after bariatric surgery. Consider vitamin A deficiency in the differential diagnosis of dry eye after LASIK surgery.

KW - bariatric surgery

KW - dry eye

KW - gastric bypass

KW - keratoconjunctivitis sicca

KW - LASIK

KW - vitamin A

UR - http://www.scopus.com/inward/record.url?scp=84870246852&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84870246852&partnerID=8YFLogxK

U2 - 10.1097/ICO.0b013e318243e4ac

DO - 10.1097/ICO.0b013e318243e4ac

M3 - Article

C2 - 22525781

AN - SCOPUS:84870246852

VL - 31

SP - 1497

EP - 1499

JO - Cornea

JF - Cornea

SN - 0277-3740

IS - 12

ER -