THE THIRD PENETRATING KERATOPLASTY IN A MONOCULAR ELDERLY PATIENT

To present the management of a monocular patient who needs a third penetrating keratoplasty to retain functional vision.

Cornea and Transplantation department, Ophthalmology Clinic, ‘’G. Gennimatas’’ Athens General Hospital

A 75-year-old monocular male due to grenade eruption when he was a child presented to the cornea and transplantation unit complaining of impaired vision of the right eye. He had a history of two penetrating keratoplasties (PKP) in the right eye in the past and the left eye was artificial. His vision was light perception and he had graft failure on the right eye. Anterior chamber was barely visible to be examined.  B ultrasound revealed attached retina and the electrophysiology was normal. The decision to perform a third PKP was undertaken, which was performed without complications. Postoperative state was unremarkable and the patient recovered functional vision.

Performing an invasive procedure when visual prognosis is favorable, is crucial in the management of monocular patients. In our patient without being able to perform a dilated fundus examination, electrophysiology and ultrasound reassured us about the functionality of the optic nerve and the visual pathway.