Epithelial Downgrowth
A patient with a history of keratoconus treated with penetrating keratoplasty, bilateral glaucoma, and cataracts underwent cataract extraction and intraocular lens implantation with iris cyst resection. Postoperatively, she developed persistent epithelial downgrowth leading to corneal decompensation, which did not respond to cutting-edge treatments such as 5-fluorouracil injections. As a novel approach, she received trans-corneal plaque brachytherapy, preceded by stem cell harvesting and followed by post-radiation transplantation. Despite efforts, culturing of aqueous fluid to detect viable epithelial cells was unsuccessful. This case presents challenges in assessing the viability of epithelial downgrowth and determining the appropriate timing for potential repeat keratoplasty, with further novel surgical options under consideration.
Presentation Date: 05/09/2024
Issue Date: 05/24/2024
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