A case report of interstitial keratitis and secondary glaucoma after cataract surgery that may be related to late congenital syphilis

作者全名："Li, Xingying; Zhou, Yu; Ma, Huafeng; Wu, Mingxing"

作者地址："[Li, Xingying; Zhou, Yu; Ma, Huafeng; Wu, Mingxing] Chongqing Med Univ, Affiliated Hosp 2, Dept Ophthalmol, Chongqing 400010, Peoples R China"

通信作者："Zhou, Y (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Dept Ophthalmol, Chongqing 400010, Peoples R China."

来源：BMC OPHTHALMOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000976066500002

JCR分区：Q3

影响因子：1.7

年份：2023

卷号：23

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Secondary glaucoma; Interstitial keratitis; Cataract surgery; Congenital syphilis

摘要："BackgroundThe destruction of blood eye barrier and the administration of corticosteroid eyedrops after phacoemulsification surgery can lead to the replication of the local potential pathogens. With the rapid increase and popularization of cataract surgery, all kinds of rare postoperative complications have appeared. Here, we report a case of interstitial keratitis and secondary glaucoma after cataract surgery, which may be related to late congenital syphilis, which eventually led to blindness in the right eye. We hope that the timely report of this case will enable doctors to pay more attention to the possibility of potential pathogen replication after cataract surgery, and enable more patients to receive reasonable and effective treatment.Case presentationA 63-year-old female was referred to our clinic for investigation with a 1-week history of moderate pain in the right eye and ipsilateral headache in January 2020. She had cataract surgery on her right eye two years ago and on her left eye one year ago. The intraocular pressure (IOP) in the right eye was 43.2 mmHg and that in the left eye was 28.5 mmHg. Her right eye underwent medication, trabeculectomy and finally was subjected to ciliary body photocoagulation to control the IOP. The IOP of the left eye was well controlled by regular use of eye drops. In addition to the elevated IOP, the inflammation of the anterior segment and corneal stroma was found. Before cataract surgery, bilateral corneal opacities was revealed, but after cataract surgery, interstitial keratitis in both eyes was gradually aggravated, during the follow-up period from 2019 to 2021. She informed us that she had suffered from decreased vision in both eyes and was diagnosed with bilateral keratitis and congenital syphilis at the age of 20. In 2018, the serologic test for syphilis was positive in blood (Chemiluminescence analysis (CLIA): + ; Toluidine red unheated serum test (TRUST): + , titer was 1:1). However, four tests for TRUST were negative in 2019 and 2020, so she was not treated for syphilis.ConclusionThis case of glaucoma and interstitial keratitis might be secondary to ocular inflammation caused by late congenital syphilis. The ocular inflammation and the activation of syphilis may be related to cataract surgery."

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