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UNUSUAL CLINICAL CASES

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Corneal Autotransplant  
 

Corneal transplantation, also known as corneal graft or keratoplasty, is a surgical procedure where a damaged or diseased cornea is replaced...

Corneal transplantation, also known as corneal graft or keratoplasty, is a surgical procedure where a damaged or diseased cornea is replaced by donated corneal tissue.

If the cornea gets hazy or cloudy, or if the shape of the cornea becomes irregular, vision can be impaired. Some of the ocular diseases that can significantly damage the cornea are the keratoconus, corneal scarring from trauma and infection, and the inherited corneal conditions (dystrophies) like Fuchs dystrophy, lattice dystrophy, and others.

For the treatment of these lesions there are several types of cornea transplants depending on which part of the cornea is damaged or how much of the cornea needs replacing, which are the following:

  • Penetrating keratoplasty - this involves transplanting all the layers of the cornea from the donor.
  • Lamellar keratoplasty -selected corneal layers are transplanted: endothelium (DSAEK - Descemet's Stripping Automated Endothelial Keratoplasty); replacement and reshape of the outer and middle cornea (DALK - Deep Anterior Lamellar Keratoplasty).

As with all types of surgery, there is a risk of complications resulting from a cornea transplant. These can include the new cornea being rejected by the body, infection and further vision problems.

The corneal autotransplant consist of transplanting a graft of the patient’s own corneal tissue from one side to the other and is indicated for the cases of a dense extensive corneal scar on a potentially seeing eye while the other side has a clear cornea in an eye with intractable and blinding lesion in the fundus. Best results are to be expected with a graft which uses the patient’s own tissues as donor material.

Anterior Segment Transplantation  
 

The anterior segment transplantation can provide visual improvement in some rare cases. The anterior segment graft includes sclera, limbus and...

The anterior segment transplantation can provide visual improvement in some rare cases. The anterior segment graft includes sclera, limbus and cornea from a donor eye.

The autotransplant consist of a graft of the patient’s own tissues from one eye to the other. It is indicated in the cases of a dense extensive corneal scar or corneal melt on a potentially seeing eye while the other eye has a clear cornea and an eye without light perception due to retinal or optic nerve lesions. Best results are to be expected with a graft which uses the patient’s own tissues as donor material.

Descemet Membrane Detachment  
 

Descemet´s membrane detachment (DMD) is an uncommon condition, that can occur after anterior segment surgeries and results in corneal edema...

Descemet´s membrane detachment (DMD) is an uncommon condition, that can occur after anterior segment surgeries and results in corneal edema at the area of detachment. DMD can be localized, extensive or total and can cause permanent corneal decompensation. The most common cause is a localized detachment occurring after cataract surgery.

Small detachments may resolve spontaneously. Treatment options include topical treatment with steroids and hyper osmotic agents, intracameral air or expansile gas injection, supra Descemet fluid drainage with intra-cameral air, viscoelastic injection or transcorneal suturing. In extensive DMD, early surgical treatment is recommended to achieve good results.