Spontaneous corneal melting during pregnancy: a case report

INTRODUCTION: Biomechanical changes in the cornea during pregnancy might lead to pathological conditions such as corneal perforation or melting. CASE PRESENTATION: A 33-year-old Asian female who underwent penetrating keratoplasty in both eyes developed corneal melting in the right eye and marginal keratitis in the left eye in her fifth month of pregnancy. Marginal keratitis in the left eye immediately subsided with topical steroid therapy. However, spontaneous corneal melting progressed in the right eye, despite oral steroid therapy and amniotic membrane transplantation. We performed tectonic penetrating keratoplasty and corneoscleral grafting in the right eye. CONCLUSION: We advise caution in the ophthalmologic care of pregnant patients who have preexisting corneal thinning disorders or who have undergone multiple corneal surgeries, because physiologic changes during pregnancy might contribute to corneal changes leading to spontaneous melting especially in patients with compromised cornea.