Dr. SHEETAL MAHUVAKAR

Abstract

In bilateral limbal stem cell deficiency (LSCD), optical penetrating keratoplasty has very poor results. There are only two options in such cases 1) Allo limbal stem cell transplant like allo-simple limbal epithelial transplant(SLET) & 2) Keratoprothesis.

Both procedures has issues like allo-SLET needs live donor for limbal biopsy & longterm systemic immunosupprssion while keratoprosthesis needs continuous use of bandage contact lens (BCL) & frequent follow ups.

In this video we present a case of modified type I keratoprosthesis done in a case bilateral LSCD. As this was post chemical injury, there were dense symblepharon which made BCL insertion impossible. BCL is very crucial in keratoprosthesis to avoid carrier graft melts, persistent epithelial defects & infections. to remove the need for BCL, we did a modification by doing keratoprosthesis under thin conjunctival pannus. We also showcase how we followed up & monitored it in strict lockdown.