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Late failure of penetrating keratoplasty with iris herniation in a single eye

Poster Details

First Author: T. Prieto Morán SPAIN

Co Author(s):    Ó. Martín Melero   J. Granados Centeno   A. Moreno Martínez   R. Maroto Cejudo   D. Espinosa Encalada        

Abstract Details


Describing the surgical management of a complicated case without clinical records by means of penetrating keratoplasty (PK) and lens extraction (LE) with a clear improvement in terms of both aesthetic and functional.


University Hospital Complex of Albacete. Albacete. Spain.


A 40-year-old argelian man presented in our clinic because of vision loss and complaints in left eye. He submitted a previous report indicating a penetrating keratoplasty (PK) in same eye and treatment based on oral acetazolamide and topical corticosteroids. On examination, best-corrected visual acuity (BCVA) in his left eye was light perception (LP) and no LP in his right eye is evidenced. The anterior segment examination shows magma composed of iris with a thin Descemet layer. Intraocular pressure (IOP) and fundal examination were invaluable.


Flieringa ring was placed and exeresis was performed on the iris, open LE before capsular staining, and PK. The outcome was acceptable and treatment with oral and topical corticosteroids, antibiotics and valaciclovir was started. The postoperative period was suitable except for high IOP that was controlled by topical hypotensive medications. BCAV was 0.7 in his left eye on logMAR scale. The patient remained unchanged for 5 months until he developed a geographic ulcer almost perforating. A new KP was proposed, but the patient no longer presented. This process has been graphically documented depicting a tremendous aesthetic improvement.


It has been proved that reporting by the patients themselves their medical condition plays a key role in properly diagnosing and subsequent pathology management. For instance, in this particular case, the patient indeed had a white cataract only appreciable on surgery. Post-surgical follow-up and treatment after PK are essential since we can find complications that seriously compromise visual function.

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