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Chapter-21 Scarred Cornea to Clear Cornea: Avoiding Penetrating Keratoplasty and Boston Keratoprosthesis

BOOK TITLE: Pre-Descemet’s Endothelial Keratoplasty (PDEK)

Author
1. Agarwal Amar
2. Narang Priya
ISBN
9789352703036
DOI
10.5005/jp/books/14154_22
Edition
1/e
Publishing Year
2018
Pages
8
Author Affiliations
1. Eye Research Centre and Dr. Agarwal’s Group of Eye Hospitals, Chennai, Bangalore, Trichy, Jaipur, Salem, Kerala, India, Dr Agarwal’s Group of Eye Hospitals and Eye Research Centre, 19 Cathedral Road Chennai, Tamil Nadu, India, Dr Agarwal’s Eye Hospital, 9, Cathedral Road, C,hennai, India, Dr Agarwal’s Eye Institute, 13 Cathedral Road, Chennai, India, Dr. Agarwal’s Eye Hospital, 19 Cathedral Road, Chennai, India, 15 Eagle Street, Langford Town Bangalore, India, Villa No. 2, Roundhouse 3, Al Wasl Road, Dubai PB 9168, Dubai, Dr. Agarwal’s Eye Hospital, 19 Cathedral Road, Chennai, India, 15 Eagle Street, Langford Town Bangalore, India, Villa No. 2, Roundhouse 3, Al Wasl Road, Dubai PB, Dubai, Dr Agarwal’s Group of Eye Hospitals, and Eye Research Centre, Chennai, India., Dr. Agarwal’s group of eye hospitals at Chennai, Bangalore, Jaipur, Salem and Trichy, India, Dr. Agarwal’s Eye Hospital, 19, Cathedral Road, Chennai-600086, India, Dr Agarwal’s Group of Eye Hospitals and Eye Research Centre 19,
2. Narang Eye Clinic, Ahmedabad (India), Narang Eye Clinic, Ahmedabad, India, M and I Institute of Ophthalmology, Ahmedabad, Narang Eye Hospital, Ahmedabad, Gujarat, India, Narang Eye Hospital Ahmedabad, Gujarat, India, Narang Eye Care and Laser Center, Ahmedabad, Gujarat, India
Chapter keywords
Cornea, scarred cornea, penetrating keratoplasty, bullous keratopathy, BK, intraocular lens, IOL

Abstract

Cornea is a transparent structure that allows passage of light into the eye and forms the first refractive media that the ray of light embarks upon before hitting the lens and retina. Currently, surgical replacement of the stroma is the only successful approach for restoration of vision in scarred corneas. The treatment of corneal scars depends upon the depth of the scar and fibrosis. Superficial keratectomy is performed for scar tissue that lies close to the epithelium and is quite superficial. The use of infant donor tissue for scarred cornea cases has helped a great deal in the clearance of corneal scar due to bullous keratopathy (BK). Aphakic and pseudophakic BK is one of the major indications for corneal grafting in many developing countries. Although pre-Descemet’s endothelial keratoplasty (PDEK) has unique advantages, it is a more technically challenging procedure in the treatment of complex BK as combined procedures are necessary in eyes with intraocular comorbidities.

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