This is a 53-year-old gentleman who had cornea transplantation in both of his eyes about 30 years ago for Keratoconus
He originally functioned well but his right eye has worsened in regard to visual acuity in the last 5-8 years: impossible to wear contact lenses or spectacles. We had evaluated him back in 2016 and his current exam in October 2020 reveals worsening of the dehiscence between the graft and host interface in the right eye between the 8 o’clock and 3 o’clock positions in the inferior arc.
We are discussing management options that will include re-suturing the graft in that area and combining higher fluence corneal cross-linking a technique that we introduced several years ago and appears to be the best option for these patients taken that the endothelial cell count is good Laservision correction at this point would probably not be the optimal option as it may exacerbate the thinning
