Dr.SAYALI MAHAJAN
The course of 2 PUK patients to stress the importance of continuous monitored immunosuppressive therapy in aggressive PUK.
A 33yrs female with active PUK BE, vision RE6/9 LE6/12, was started on steroids. She was lost to follow-up and presented with BE corneal perforation after 5months. Following BE corneal patch graft and systemic immunosuppresants, she defaulted several times to present with multiple PUK recurrences complicated by fungal keratitis in RE.Eventually after 2 more therapeutic penetrating keratoplasties in each eye, her final vision was HM+ in BE.
In stark contrast, a 51yrs male with LE active PUK with BE6/6 vision was started on steroids but again lost to follow-up and presented with LE perforated PUK with advanced cataract and HM+ vision after 8months. Corneal patch graft was done and patient was started on systemic immunosuppresants.He has been compliant to medication and has followed-up regularly. He underwent cataract surgery and has final LE vision 6/9.
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