Dr. SUNITA PANDEY

DR. RADHIKA NATARAJAN

Abstract

A 45 year old single eyed male patient with Xeroderma pigmentosum(XP) & under palliative care for end stage systemic malignancy, with history of two Penetrating Keratoplasty(PK) elsewhere, presented with near total corneal graft infiltrate with 2mm nasal papillomatous growth suggestive of OSSN. Therapeutic PK with mass excision+cryotherapy using non-touch technique was done. Excised button revealed septate fungal filaments and topical Voriconazole was started. No recurrence of infection and OSSN at 2 month follow-up with subsequent graft failure. Underwent type 1 keratoprosthesis(K-PRO) with best corrected visual acuity (BCVA) of 6/18. Patient’s sister, also one-eyed & with XP & multiple failed PKs elsewhere in her only eye, underwent PK+ Allo-SLET and maintaining BCVA 6/36 at 10 months follow up. To conclude, PK is risky in XP due to limbal deficiency with coexistent OSSN & infection, increasing chances of failure. K-PRO in visual rehabilitation may be needed due to surface issues