Persistent Epithelial Defects Caused by Limbal Deficiency for Various Causes

Purpose: We report the process of treating persistent corneal epithelial defects due to limbal deficiency in a patient who underwent surgery for ptosis, recurrent pterygium, and senile cataract for 3 weeks. Case summary: A 65-year-old male patient underwent cataract surgery 4 months ago and visited this hospital with persistent inflammation of the left cornea that started 2 months ago. The patient underwent blepharoplasty and pterygium surgery at the same time 3 weeks before cataract surgery. At the first visit, severe conjunctival injection and an oval-shaped corneal epithelial defect with a size of 3 x 5 mm in the center of the cornea were seen. As the result of the eyelid eversion test, fibrotic scar tissue due to the non-absorbable suture used during the upper eyelid blepharoplasty was observed and surgically removed. The corneal epithelial defect site became smaller, but the atrophy of the corneal stroma was sustained, and the amniotic membrane was tripled and permanent amniotic membrane transplantation was performed. Corneal epithelial defects have improved with post-operative best-corrected visual acuity of 0.15. Conclusions: Sufficient recovery period between serial multiple surgeries is required to reduce the occurrence of complications like persistent epithelial defects.