PMC9193368_01
(A) Peripheral ulcerative keratitis (PUK) seen in Case 1's right eye with 2 discrete areas of severe peripheral corneal melt spanning 2 clock hours nasally and 2 clock hours temporally (B). Corresponding staining of areas of cornea melt temporally and nasally (C). Epithelization over the two areas of cornea melt by day 9 of treatment (D). Corresponding area of pooling temporally and nasally showing epithelization of the stromal melt.
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F1
There was no scleritis (Figures 1A,B). By day 9 of treatment, the area of corneal thinning had epithelized and there was no further stromal melting (Figures 1C,D).
PMC9193368_02
(A) Peripheral ulcerative keratitis (PUK) seen in Case 2's left eye temporally. (B) Corresponding AS-OCT cuts through the areas of thinning in each eye, respectively. (C) Corresponding staining of areas of cornea melt temporally. (D) Left Amniotic Membrane Transplant (AMT) in view of PUK progression. (E) Post repeat conjunctival recession, AMT and tectonic keratoplasty in view of PUK recurrences, with another new epithelial defect over the graft. (F) Corresponding staining of areas of cornea melt temporally over the tectonic graft. (G) Last AMT performed with no further recurrences of PUK over a 3-year follow-up period. (H) Corresponding AS-OCT cuts through the areas of thinning in each eye, respectively.
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F2
There was no scleritis (Figures 2A-C). Despite this, her thinning progressed further to 80% and she underwent a left eye amniotic membrane transplant (AMT) (Figure 2D). She later needed further conjunctival recession, repeat amniotic membrane transplant and tectonic graft over the course of 2 years in view of repeated flares of her PUK with graft melting (Figures 2E,F). Her ocular condition remained quiescent with no further recurrences over a 3-year follow-up period (Figures 2G,H).
PMC9193368_03