Temporary Lateral Tarsorrhaphy In Managing Corneal Ulceration Related To Facial Nerve Palsy : Case Report

Eka Rosdiana, Cut Putri Samira

Sari


Corneal ulceration is a breach in the corneal epithelial surface that can lead to blindness. Facial nerve palsy can lead to inadequate eyelid closure and reducing lubrication of the eye's surface. A 58-year-old man presented with a one-month history of worsening blurred vision, pain, and a whitish spot in the Right Eye (RE). He had been diagnosed with facial nerve palsy three months prior which hadn’t improved. Ophthalmic examination revealed reduced visual acuity, conjunctival hyperemia, hypopyon, and lagophthalmos with corneal exposure in RE. Fluorescent test showed 4x5 mm corneal ulceration with infiltrate. A neurological examination confirmed facial nerve involvement. After pharmacological treatment, a follow-up showed resolution of hypopyon but a persistent corneal ulcer with infiltrate. Long-term corneal exposure from lagophthalmos can cause corneal ulceration and thinning, especially in the lower part of cornea. This poses a therapeutic challenge. A temporary lateral tarsorrhaphy was performed to encourage healing of the corneal surface by optimizing eyelid positioning. One month post-procedure, the ulcer showed good re-epithelialization.


Kata Kunci


Corneal ulceration; Corneal exposure; Facial nerve palsy; Tarsorrhaphy

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Referensi


Alhoutan, K., & Alarfaj, K. (2021). Exposure Keratopathy: An Idiopathic Lagophthalmos Case Report. Cureus. https://doi.org/10.7759/cureus.18945

Asroruddin, M., Nora, R. L. D., Edwar, L., Sjamsoe, S., & Susiyanti, M. (2015). Various factors affecting the bacterial corneal ulcer healing: A 4-years study in referral tertiary eye hospital in Indonesia. Medical Journal of Indonesia, 24(3), 150–155. https://doi.org/10.13181/mji.v24i3.1044

Byrd LB, G. B. M. N. (2024). Corneal Ulcer. 2024 Feb 12. In: StatPearls [Internet]. Treasure Island (FL). StatPearls PMID: 30969511.

Cheng, A. S., Giri, P., Byanju, R., Pradhan, S., Ligal, A., Bhandari, G., Bhandari, S., Kandel, R. P., Poudyal, B., Srinivasan, M., Upadhyay, M., Whitcher, J. P., Lietman, T. M., Keenan, J. D., & O’Brien, K. S. (2024). Corneal ulcers and the risk of visual impairment in a matched cohort study in Nepal. AJO International, 1(1), 100012. https://doi.org/10.1016/j.ajoint.2024.100012

Fagien, S. (2018). Tarsorrhaphy and Eyelid Traction Sutures. In Manual of Oculoplastic Surgery (pp. 287–291). Springer International Publishing. https://doi.org/10.1007/978-3-319-74512-1_29

Fu L, P. B. (2023). Lagophthalmos. In: StatPearls [Internet]. StatPearls Publishing; 2023. Available from: Https://Www.Ncbi.Nlm.Nih.Gov/Books/NBK560661/.

Journal, O., Moshirfar, M., Hopping, G. C., Vaidyanathan, U., Liu, H., Somani, A. N., Ronquillo, Y. C., & Hoopes, P. C. (2019). Infectious Keratitis: Controversy in Clinical Utility. Med Hypothesis Discov Innov Ophthalmol. In Discov Innov Ophthalmol (Vol. 8, Issue 3).

Kenia, V. P., Kenia, R. V, & Pirdankar, O. H. (2020). Diagnosis and Management Protocol of Acute Corneal Ulcer. In International Journal of Health Sciences and Research (www.ijhsr.org) (Vol. 10). www.ijhsr.org

Lew, H., & Lee, S. (2019). Ophthalmologic Clinical Features of Facial Nerve Palsy Patients. Korean J Ophthalmol, 33(1), 1–7. https://doi.org/10.3341/kjo

Mark B. (2023). The Approach to Diagnosis and Management of Corneal Ulcers. In Journal of Ophthalmology and Visual Sciences (Vol. 8, Issue 2). www.austinpublishinggroup.com

Ozir, M. A., & Hashim, S. E. (2024). Online First Indian J Case Reports 1 Case Report Exposure keratopathy secondary to lagophthalmos with facial nerve palsy-Challenges in management. http://www.med.umich.edu/1libr/ophthalmology/comprehensive/

Sandyakala Purnama, D., Maulida, H. N., Setya Angtika, R., Hendayanti, A., & Satria, A. M. (n.d.). Inovation Of Collagen Based Corneal Hydrogel with the Addition Of Glycopolymer As the Solution For Irreversible Blindness By Corneal Ulcers.

Sohrab, M., Abugo, U., Grant, M., & Merbs, S. (2015). Management of the eye in facial paralysis. Facial Plastic Surgery, 31(2), 140–144. https://doi.org/10.1055/s-0035-1549292

Stamate, A.-C., Tătaru, C. P., & Zemba, M. (2019). Update on surgical management of corneal ulceration and perforation. Romanian Journal of Ophthalmology, 63(2), 166–173. https://doi.org/10.22336/rjo.2019.25

Zhang, X., Mélik-Parsadaniantz, S., Baudouin, C., Goazigo, A. R. Le, & Moreau, N. (2022). Shhedding New Light on the Role of Hedgehog Signaling in Corneal Wound Healing. In International Journal of Molecular Sciences (Vol. 23, Issue 7). Multidisciplinary Digital Publishing Institute (MDPI). https://doi.org/10.3390/ijms23073630




DOI: https://doi.org/10.33024/jikk.v11i12.18786

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