INFECTIOUS KERATITIS WITH CORNEAL PERFORATION ASSOCIATED WITH CORNEALHYDROPS AND CONTACT-LENS WEAR IN KERATOCONUS

Background - Corneal perforation is an uncommon complication associate d with keratoconus. The first cases of infectious keratitis and cornea l perforation associated with corneal hydrops and contact lens wear ar e reported in two keratoconus patients. Methods - A retrospective char t review and histopathological examination were carried out. Results - Both patients progressed to corneal perforation and emergency penetra ting keratoplasty. One patient cultured Fusarium and the second patien t Serratia marcesens. Both patients wore contact lenses against medica l advice. Conclusions - The tear in Descemet's membrane, stromal oedem a, and epithelial bedewing associated with corneal hydrops results in loss of the epithelial-endothelial barrier of the cornea, creating a c onduit for infectious organisms through the cornea. Acute hydrops asso ciated with epithelial keratitis, stromal swelling, and a Descemet's m embrane tear may be a significant risk factor for infectious keratitis and corneal perforation. Contact lenses should not be worn during an active corneal hydrops owing to the increased risk for severe infectio us keratitis and corneal perforation.