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Tectonic Lamellar Keratoplasty Using Cryopreserved Cornea in a Large Descemetocele

 Kang Yoon Kim  ;  Ji Won Jung  ;  Eung Kweon Kim  ;  Kyoung Yul Seo  ;  Tae-im Kim 
 YONSEI MEDICAL JOURNAL, Vol.57(1) : 269-271, 2016 
Journal Title
Issue Date
Cornea/surgery* ; Corneal Perforation/pathology ; Corneal Perforation/physiopathology ; Corneal Perforation/surgery* ; Corneal Transplantation/methods* ; Cryopreservation* ; Eye Injuries, Penetrating/pathology ; Eye Injuries, Penetrating/physiopathology ; Eye Injuries, Penetrating/surgery* ; Female ; Humans ; Keratoplasty, Penetrating ; Male ; Middle Aged ; Tissue Donors* ; Treatment Outcome ; Visual Acuity
Tectonic keratoplasty ; cryopreserved cornea ; descemetocele
We describe herein a case of an impending corneal perforation with a large descemetocele in a patient with previous penetrating keratoplasty (PKP) that subsequently was treated with an emergent lamellar keratoplasty using frozen preserved cornea. A 76-year-old male patient, who had a PKP, presented with a completely whitish and edematous graft accompanied by large epithelial defects. Although antibiotics and antiviral agents were tried for three days, the corneal stroma abruptly melted, except for the Descemet's membrane and endothelium. Cryopreserved corneal tissue that was kept at -80°C was thawed and sutured on top of the remaining Descemet's membrane and endothelium. Pathological and microbiological tests were conducted using the remaining donor and recipient corneal tissues. After tectonic corneal transplantation on top of a large descemetocele, a healthy graft and relatively clear interfaces between graft-host junctions were maintained without serious adverse reactions throughout 6 month follow-up period. Microbiological evaluations of donor tissue at the time of thawing and tissue preparation were done, and the results were all negative. Tissue that was taken intraoperatively from the recipient cornea also showed negative microbiological results. In conclusion, tectonic lamellar keratoplasty, using cryopreserved corneal tissue, only onto the remaining Descemet's membrane and endothelium in an emergent condition, was a safe and effective treatment.
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1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kang Yoon(김강윤)
Kim, Eung Kweon(김응권) ORCID logo https://orcid.org/0000-0002-1453-8042
Kim, Tae Im(김태임) ORCID logo https://orcid.org/0000-0001-6414-3842
Seo, Kyuong Yul(서경률) ORCID logo https://orcid.org/0000-0002-9855-1980
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