case_images: PMC11324278_01
case_images: Case 1 anterior segment before and after PK and IOL scleral fixation using Landers TKP. a Image of slit-lamp microscope before surgery. Bullous keratopathy presenting corneal edema of the transplanted cornea was observed. b Fluorescent staining image of the anterior segment before surgery. Corneal edema was confirmed with fluorescent staining. c Image of anterior-segment optical coherence tomography before surgery. Corneal edema was noted with a central corneal thickness of 1,092 mum. No IOLs were used. d Image of slit-lamp microscope after surgery. The transplanted cornea was clear, and the intraocular condition was clearly confirmed. e Fluorescent staining image of the anterior segment after surgery. There was no epithelial defect or corneal edema. f Image of anterior-segment optical coherence tomography after surgery. Corneal edema was not observed. Intraocular fixation was confirmed. The IOL was visible (arrow). IOL, intraocular lens; PK, penetrating keratoplasty; TKP, temporary keratoprosthesis.
case_images: cop-2024-0015-0001-540287_F01.jpg
case_images: PMC11324278_01_cop-2024-0015-0001-540287_F01.jpg
case_images: F1
case_images: Owing to the corneal stromal opacity and corneal edema, the translucency of the anterior chamber was poor (Fig. 1a, b). Anterior-segment optical coherence tomography revealed severe edema in the previous corneal graft (Fig. 1c). Graft clarity, anterior chamber transparency, and epithelial condition were satisfactory 3 years post-surgery (Fig. 1d, e). Corneal endothelial cell density was maintained at 1,005 cells/mm2, and the central cornea thickness was 609 mum (Fig. 1f).
case_images: PMC11324278_02
case_images: Case 2 anterior segment before and after PK and IOL scleral fixation using Landers TKP. a Image of slit-lamp microscope before surgery. A thickened opaque cornea after therapeutic keratoplasty was noted. b Image of anterior-segment optical coherence tomography before surgery. Corneal edema was noted with a central corneal thickness of 834 mum. c Surgeon's view of the microscope on suturing the Landers TKP to the cornea after punching out the recipient cornea. d Surgeon's view of the microscope on intrascleral fixation of the IOL. e Image of slit-lamp microscope after surgery. f Image of anterior-segment optical coherence tomography after surgery. No corneal edema was noted, with a central corneal thickness of 594 mum. The IOL was visible (arrow). IOL, intraocular lens; PK, penetrating keratoplasty; TKP, temporary keratoprosthesis.
case_images: cop-2024-0015-0001-540287_F02.jpg
case_images: PMC11324278_02_cop-2024-0015-0001-540287_F02.jpg
case_images: F2
case_images: Subsequently, we performed therapeutic PK with anterior vitrectomy using a cryopreserved cornea, but his corneal graft thickened with subepithelial edema, resulting in graft failure (Fig. 2a). The central corneal thickness was 834 mum (Fig. 2b). Under general anesthesia, the Landers TKP (7.2 mm diameter) was sutured using 10-0 Nylon after punching off a 7 mm wide recipient cornea (Fig. 2c). Next, the IOL was fixed intrasclerally using the Yamane technique (Fig. 2d). The corneal graft became clear 1-month post-surgery (Fig. 2e) without corneal edema, as evaluated using anterior-segment optical coherence tomography (Fig. 2f).