Large optico‐reconstructive corneal grafts in complicated cases

Abstract

AbstractPurpose Demonstration of different procedures for eye surface reconstruction and visual rehabilitation in complicated conditions.Methods Case 1: LASIK photokeratomileusis is demonstrated in a case previously operated for penetrating keratoplasty. Case 2: Optico‐reconstructive penetrating 11 mm keratoplasty performed in a case of bilateral keratoconus‐keratoglobus. The fellow eye had been operated for 11 mm penetrating keratoplasty 20 years earlier, with good result. Two years after the operation of the second eye opacification of the graft developed in the second eye due to irreversible homograft reaction. A second penetrating graft, 7.6 mm in diameter was performed in the center of the previous, opaque, graft. The procedure was combined with simultaneous extracapsular lens removal and IOL implantation.Results The excellent results of these three examples of complicated large penetrating corneal grafts are demonstrated in all three cases with video and slides.Conclusion The prognosis of large diameter optico‐reconstructive penetrating keratoplasties in apparently unfavourable situations can be definitely improved selecting appropriate surgical indications, combined with a meticoulus surgical technique, adequate postoperative medication (local and systemic corticosteroids, cyclosporine A eye drops 2 %, immunosuppressors, topical cycloplegics, etc.)and rigurous postoperative follow‐up control.