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February 1983

Corneal Melting Syndrome-Reply

Author Affiliations

Columbia, Mo
Woodbury, NJ

Arch Ophthalmol. 1983;101(2):303. doi:10.1001/archopht.1983.01040010305025

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In Reply.  —We were impressed by the intriguing similarities between our article and the article by Dr Gelender. In both series, elderly patients having had intraocular lens surgery underwent corneal epithelial disturbances that progressed to frank melting after a latent period of several weeks. Implant removal was of benefit in selected cases.Why was such corneal melting less prevalent before the widespread use of intraocular lenses? Perhaps the implant itself provoked an inflammatory response sufficient to contribute to the melting, as suggested by Dr Gelender. In support of this theory is the observation that corneal reepithelialization was prompted following implant removal in both series. Another possibility is that with implants, more steroid therapy is warranted postoperatively, and it is the liberal use of corticosteroids that was crucial to the pathogenesis of the melting.Whereas all five of the patients in our series had either keratitis sicca or rheumatoid arthritis, only

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