Cataract/Anterior Segment, Cornea/External Disease

    Dr. Jaime Martinez and Pietro Carletti describe the use of a stacked 5-part “quintuple” procedure, aimed at visual rehabilitation and surface optimization, in a patient with a history of contact lens wearing and recurrent chronic infectious keratitis that led to visually impairing corneal scarring and conjunctivalization. The 5 components of this approach are deep anterior lamellar keratoplasty to clear the corneal scarring, cataract extraction, IOL implantation for visual rehabilitation, autologous simple limbal epithelial transplantation to address the patient's partial limbal stem cell deficiency and restore ocular surface function, and a temporary tarsorrhaphy to promote surface epithelialization and graft survival. Best-corrected visual acuity improved from counting fingers at presentation to 20/80 at 6 weeks following surgery.

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