Three Corneal Transplants in Three Years due to rejection

The 3 photos shown here were taken recently of the same eye. This eye underwent 3 corneal transplant surgeries over the past 3 years. The reason for 3 corneal transplants was rejection of the prior 2 transplanted corneas. The original underlying reason for these surgeries was keratoconus. The point of my showing these photos is to demonstrate the ripple effect of ocular surgeries.Corneal transplant surgery has also been done on many patients who developed post-LASIK corneal ectasia, which has a similar ocular presentation to keratoconus. For over 2 years this eye was subjected to topical steroid drops multiple times daily in order to prevent rejection of the transplanted corneas. As a result of the steroids, this eye developed glaucoma. The intra ocular pressure in this eye could not be lowered to a proper level to prevent damage to the internal ocular structures. As a result 2 glaucoma shunts were surgically implanted into this eye to allow the proper outflow of the intraocular fluid (aqueous). In the first photo you can see the corneal transplant. If you look carefully you can make out the faint shadows of the glaucoma shunts. In the 2nd and 3rd photos note the large bulbous areas on the white portions of this eye. These are due to the glaucoma shunts. This eye is being fit with a specialty scleral lens which will provide clear vision once again. For many years I have told patients to avoid all types of refractive surgeries. I have also told patients who did develop post-LASIK complications to avoid “enhancements” due to the risk of additional irreversible problems. I hope that these photos bring home this point.

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