AMAZING OUTCOME OF A CATARACT SURGERY AFTER KERATOPLASTY WITH DOUBLE LAYER SMILE-DERIVED LENTICULE GRAFTS IN CORNEAL PERFORATION.

PKP is the traditional procedure to treat corneal perforation. However, the irregular astigmatism is the main cause of the low vision after surgery. Keratoplasty with double layer SMILE-derived lenticule graft is an excellent option to achieve a regular and smooth ocular surface and easy for pre-cataract surgery biometric measurement.

A cataract surgery case after keratoplasy with SMILE-derived lenticule graft was reported.

A 68 yrs. old man suffered from progressive visual impairment in 4 months after his right eye keratoplasty procedure.

Four months ago, the right eye had a corneal ulcer perforation. A double-layer lamellar keratoplasty using frozen SMILE-derived lenticule grafts was performed. The inner 1.5*1.5mm small graft layer was sutured to repair the perforation, and the outer 5 * 5mm graft layer was embedded into the corneal stroma.

Preoperative PE of the right eye: BCVA: 3/20, corneal graft was transparent and the surface was regular and smooth, the inner graft was opacified and in place. Anterior synechia of the iris, and cortical and nuclear lens opacity were observed. Corneal topography showed little astigmatism. Complicated cataract was diagnosed. Surgery: Phaco+IOL implantation +PCCC +anterior vitrectomy were performed. Post-op 1 day UCVA: 20/20, with IOP 13mmHg, central corneal transparency, pupil shape was same as Pre-op, IOL located in the capsular bag with absence of central posterior capsule. Post-op 1 week UCVA: 20/20, not obvious anterior chamber inflammation was observed.

SMILE-derived lenticule is an excellent option for repairing corneal ulcer perforation, which helps to achieve better visual acuity after cataract surgery.