DR.JITENDER JINAGAL

, DR. AMIT GUPTA, Dr. ARUN KUMAR JAIN

Abstract

A 7 year old male presented with history of left eye chemical injury one year back. Best corrected visual acuity was 6/6 and PL+. Left eye examination revealed grade 3/4 symblepharon, complete pannus over cornea, total Limbal stem cell deficiency and corneal scarring. USG was normal. ASOCT showed full thickness corneal scarring. Right eye was normal. We managed this condition in targeted approach in a staged manner. In the first stage, left eye symblepharon release with pannus excision and 360 degree conjunctival autograft around limbus along with simple limbal epithelial transplantation from right eye was done. In second stage, penetrating keratoplasty with amniotic membrane transplantation was done. Post operatively at 2 weeks, we achieved a well epithelized stable clear corneal graft and BCVA of 6/60 (-1.5DS/-5.00DCx20) . IOP was 16 mm of Hg. Amblyopia therapy was initiated. To conclude, by meticulous planning satisfying anatomical and functional outcomes can be achieved.