A peculiar case of corneal autograft in a patient with bilateral advanced glaucoma

Sneha Thapliyal,Sri Ganesh,Vipul Bhandari

doi:10.35119/asjoo.v16i4.398

Abstract

The technique of autograft employs the use of a clear corneal graft from an otherwise blind eye that is transplanted to the fellow eye, which has a visual potential in the same patient. A patient with advanced glaucoma in both eyes presented to us with pseudophakic bullous keratopathy with Ahmed glaucoma valve in the right eye, and cataract and patent peripheral iridotomy with no perception of light in the left eye. The autograft and allograft corneas for bilateral penetrating keratoplasty (PK) were obtained from the contralateral eye and a cadaver eye, respectively. Central corneal button was used for PK. One year after the surgery, the graft host junction was well apposed with no vascularization, corneal surface was clear, sutures were intact, and best corrected visual acuity improved in right eye to 1 logMAR. Bilateral simultaneous PK with autograft in one eye and allograft in the other was done to decrease the chances of rejection.

Highlights

The technique of autograft employs the use of a clear corneal graft from an otherwise blind eye that is transplanted to the fellow eye, which has a visual potential in the same patient
Simultaneous bilateral penetrating keratoplasty (PK) was performed, with the right eye cornea trephined and transplanted with the blind eye cornea, while the latter was transplanted with donor tissue
There has not been any report on bilateral simultaneous PK in the Indian scenario, which makes our case unique: the blind eye cornea was transplanted to the seeing eye diagnosed with pseudophakic bullous keratopathy (PBK), while the former received a donor cornea

Summary

Introduction

The technique of autograft employs the use of a clear corneal graft from an otherwise blind eye that is transplanted to the fellow eye, which has a visual potential in the same patient. The common indications for the procedure of autografts are aphakic bullous keratopathy, pseudophakic bullous keratopathy (PBK), and healed herpetic keratitis.[1,2] The donor eye must have a clear cornea and must be blind, possibly due to posterior segment pathology, which in this case is advanced glaucoma. The patient’s left eye was blind with no perception of light, while the right eye had PBK.

Results

Conclusion