Sterile Corneal Perforation Occurring Several Years After Biliopancreatic Diversion

Obes Surg. 2020 Jul;30(7):2847-2850. doi: 10.1007/s11695-020-04523-2.

Abstract

Background: To report the first two cases of sterile corneal perforation secondary to vitamin A deficiency after biliopancreatic diversion with duodenal switch (BPD/SW).

Methods: Observational case series.

Results: Two patients with a history of BPD/SW presented with corneal perforation associated with conjunctival xerosis and keratopathy. In both cases, serum vitamin A level dosage revealed a marked deficit, and the patients admitted poor compliance with vitamin supplementation. Oral therapy with vitamin A was started immediately, and in one case ocular surgery was performed to preserve the integrity of the globe.

Conclusions: Ophthalmologists should carefully examine the ocular surface of patients undergone bariatric surgery in order to promptly recognize the signs of vitamin A deficiency and avoid serious sight-threatening complications.

Keywords: Biliopancreatic diversion; Corneal perforation; Vitamin A; Xerophthalmia.

MeSH terms

  • Biliopancreatic Diversion* / adverse effects
  • Corneal Perforation* / etiology
  • Corneal Perforation* / surgery
  • Humans
  • Obesity, Morbid* / surgery
  • Vitamin A Deficiency* / drug therapy
  • Vitamin A Deficiency* / etiology
  • Xerophthalmia*