Frontiers in Medicine (Oct 2024)
Case report: Two-step lamellar keratoplasty for alkali burns
- Xie Fang,
- Xie Fang,
- Xie Fang,
- Xie Fang,
- Xie Fang,
- Xie Fang,
- Zhiwen Xie,
- Zhiwen Xie,
- Zhiwen Xie,
- Zhiwen Xie,
- Zhiwen Xie,
- Zhiwen Xie,
- Shunrong Luo,
- Shunrong Luo,
- Shunrong Luo,
- Shunrong Luo,
- Shunrong Luo,
- Shunrong Luo,
- Xianwen Xiao,
- Xianwen Xiao,
- Xianwen Xiao,
- Xianwen Xiao,
- Xianwen Xiao,
- Xianwen Xiao,
- Zhengwei Yang,
- Zhengwei Yang,
- Zhengwei Yang,
- Zhengwei Yang,
- Zhengwei Yang,
- Zhengwei Yang,
- Yuan Lin,
- Yuan Lin,
- Yuan Lin,
- Yuan Lin,
- Yuan Lin,
- Yuan Lin,
- Huping Wu,
- Huping Wu,
- Huping Wu,
- Huping Wu,
- Huping Wu,
- Huping Wu
Affiliations
- Xie Fang
- Xiamen Eye Center and Eye Institute of Xiamen University, School of Medicine, Xiamen, China
- Xie Fang
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, China
- Xie Fang
- Xiamen Key Laboratory of Ophthalmology, Xiamen, China
- Xie Fang
- Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, China
- Xie Fang
- Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, China
- Xie Fang
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, China
- Zhiwen Xie
- Xiamen Eye Center and Eye Institute of Xiamen University, School of Medicine, Xiamen, China
- Zhiwen Xie
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, China
- Zhiwen Xie
- Xiamen Key Laboratory of Ophthalmology, Xiamen, China
- Zhiwen Xie
- Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, China
- Zhiwen Xie
- Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, China
- Zhiwen Xie
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, China
- Shunrong Luo
- Xiamen Eye Center and Eye Institute of Xiamen University, School of Medicine, Xiamen, China
- Shunrong Luo
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, China
- Shunrong Luo
- Xiamen Key Laboratory of Ophthalmology, Xiamen, China
- Shunrong Luo
- Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, China
- Shunrong Luo
- Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, China
- Shunrong Luo
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, China
- Xianwen Xiao
- Xiamen Eye Center and Eye Institute of Xiamen University, School of Medicine, Xiamen, China
- Xianwen Xiao
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, China
- Xianwen Xiao
- Xiamen Key Laboratory of Ophthalmology, Xiamen, China
- Xianwen Xiao
- Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, China
- Xianwen Xiao
- Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, China
- Xianwen Xiao
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, China
- Zhengwei Yang
- Xiamen Eye Center and Eye Institute of Xiamen University, School of Medicine, Xiamen, China
- Zhengwei Yang
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, China
- Zhengwei Yang
- Xiamen Key Laboratory of Ophthalmology, Xiamen, China
- Zhengwei Yang
- Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, China
- Zhengwei Yang
- Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, China
- Zhengwei Yang
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, China
- Yuan Lin
- Xiamen Eye Center and Eye Institute of Xiamen University, School of Medicine, Xiamen, China
- Yuan Lin
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, China
- Yuan Lin
- Xiamen Key Laboratory of Ophthalmology, Xiamen, China
- Yuan Lin
- Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, China
- Yuan Lin
- Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, China
- Yuan Lin
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, China
- Huping Wu
- Xiamen Eye Center and Eye Institute of Xiamen University, School of Medicine, Xiamen, China
- Huping Wu
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, China
- Huping Wu
- Xiamen Key Laboratory of Ophthalmology, Xiamen, China
- Huping Wu
- Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, China
- Huping Wu
- Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, China
- Huping Wu
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, China
- DOI
- https://doi.org/10.3389/fmed.2024.1496083
- Journal volume & issue
-
Vol. 11
Abstract
PurposeTo report a case of a patient with ocular surface alkali burn who developed corneal perforation before entering a stable phase. This patient was treated with a custom-designed lamellar graft using a Two-Step lamellar keratoplasty (LK) after 3 months alkali burn.MethodsThis study was a case report.ResultsA 43-year-old male patient who presented with redness, pain, and decreased vision in his left eye following lime exposure. Initial treatment involved amniotic membrane transplantation and anterior chamber irrigation. However, the patient subsequently developed corneal infiltration and progressive thinning. The patient refused the corneal transplantation and ultimately underwent tarsorrhaphy. Twenty days postoperatively, the patient experienced sudden ocular pain and central corneal perforation. Considering the potential complications of conventional corneal transplantation, including stem cell deficiency, graft dissolution, and rejection, a personalized Two-Step LK was devised. Following this procedure, the patient’s vision gradually improved to 20/133 (without correction), with a good corneal condition but mild epithelial defects and edema. At the 8-month follow-up, subepithelial corneal haze was observed, but uncorrected visual acuity remained stable at 20/133 and best corrected visual acuity was up to 20/66.ConclusionFor patients with ocular surface alkali burns who experience persistent disease progression despite early and mid-stage aggressive interventions, this study is the first to report on the use of a Two-Step LK. This approach takes into account both the “soil” factors that may lead to graft dissolution and the “seed” factors related to recipient stem cell deficiency. The results in preventing graft dissolution and maintaining postoperative corneal function are encouraging.
Keywords
- alkali burns
- ocular surface
- lamellar keratoplasty
- corneal perforation
- two-step lamellar keratoplasty
- femtosecond laser
