Rehabilitation of a patient with subtotal corneal melting associated with contact lenses, based on penetrating keratoplasty using cryopreserved cornea and subsequent transplantation of viable endothelium: 3 years of follow-up

    Abstract

    Rehabilitation of a patient with subtotal corneal melting associated with contact lenses, based on penetrating keratoplasty using cryopreserved cornea and subsequent transplantation of viable endothelium: 3 years of follow-up

    A.N. Pashtaev, D.N. Sushencova, A.Z. Ciganov

    The S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation

    Purpose. To evaluate the clinical and functional results of transplantation of viable endothelium after penetrating keratoplasty with cryopreserved cornea subjected to the cross-linking procedure for the treatment of a patient with subtotal corneal melting associated with contact lenses.

    Material and methods. The patient B., 33 years old. Diagnosis at admission: OS – purulent corneal ulcer with perforation. From the anamnesis: she used soft contact lenses that were not daily replaced, for a month she underwent treatment in one of the Moscow clinics for keratitis, where she underwent epikeratoplasty. Treatment was performed without positive effect. Upon admission to the Fyodorov Institution, an emergency penetrating keratoplasty with a cryopreserved cornea and subsequent conservative treatment was performed. One year after penetrating keratoplasty, the phacoemulsification with intraocular lens implantation + DSAEK was performed, followed by conservative treatment.

    Results. Transparent engraftment was observed, no corneal edema was identified. best spectacle-corrected visual acuity was 0,4. Endothelial cell density – 1047 cells/mm2. Astigmatism was 4,25 D.

    Conclusion. Cryopreserved cornea subjected to the cross-linking procedure allows to preserve the structural properties of its stroma. Subsequent transplantation of viable endothelium by DSAEK allows to restore the optical properties of the cornea and to achieve visual rehabilitation of the patient.

    Key words: penetrating keratoplasty, cryopreserved cornea, posterior keratoplasty, DSAEK

    For quoting: Pashtaev A.N., Sushencova D.N., Ciganov A.Z. Rehabilitation of a patient with subtotal corneal melting associated with contact lenses, based on penetrating keratoplasty using cryopreserved cornea and subsequent transplantation of viable endothelium: 3 years of follow-up. Clinical cases in ophthalmology. 2022;1: 14–19.

    Corresponding author: Aleksey N. Pashtaev, pashtaevmd@gmail.com